Ronald Reagan's 1987 proposal to change the federal Medicare system to help protect against the costs of "catastrophic illness" seemed to portend an important change in the US social insurance system. And, indeed, an amended version of the Reagan proposal did become law in relative short order. By 1988, however, a grassroots revolt began to take shape against the new law, which offered new benefits but also imposed new charges on the elderly. This case tells the story of the factors which conspired to lead Congress, in a virtually unprecedented step, to repeal "catastrophic" only a year after its passage. The case focuses on the dynamics which drive Congress--the role of interest groups (such as the American Association of Retired Persons), committee and personal staff, grassroots as well as so-called "Astroturf" organizing campaigns.
The case allows for discussion both of the legislative process and the forces which affect it, as well as the substance of US social policy and politically acceptable and unacceptable ways to alter it. In addition, it provides a primer in the structure of federal health insurance programs.