The Reforming States Group (RSG), which operated between 1992 and 2021, had a proud history of education, collegiality, and health policy leadership. The group got its start when the Milbank Memorial Fund was asked, over a period of time in the 1990s, to convene meetings so that policymakers could speak with one another about health policy issues. One of the first requests came in 1991 from Michigan State Representative David Hollister, who suggested that the Fund convene a meeting to define criteria for retrenching health and social service programs during the recession that had just begun. Chair of the House Appropriations Subcommittee for Health and Social Services during a time of deep budget cuts, Hollister thought his colleagues in similar positions would welcome a paper that offered guidance. The Fund agreed to assist Representative Hollister, but only if the paper presented the best bipartisan thinking and had the endorsement of people like himself—decision makers who were accountable to the electorate. That meeting produced a pamphlet, Hard Choices in Hard Times: Guidelines for Decision Makers in Health and Human Services.

The next year, the Fund was asked to organize several other bipartisan meetings on access to health care. In 1992, it brought together a bipartisan group of leaders from five states to share with one another first-hand experience from the front lines of health care reform. This meeting, held in Mt. Hood in Oregon, is viewed as the birth of the organization that became the RSG. The five states that attended—Florida, Hawaii, Minnesota, Oregon, and Vermont—were known, at the time, as “the states that could not wait.” They were breaking ground in health care policy—and not going to wait for the federal government to address the issues.

It soon became clear that helping policymakers share with one another the policies and politics of reform offered them a welcome opportunity, one that they did not have elsewhere.

By 1993, officials who had participated in these meetings started to call themselves the Reforming States Group (RSG). The issue of federal-state collaboration in reform was vital to the group’s members, and the RSG became known to White House staff, interest groups, Congress, and the news media as a reliable, balanced source of information.

In 2017, the RSG celebrated its 25th Anniversary.