By now, “Harry and Louise” have become a Washington cliché, as in, “Will the health care effort this time around be Harry and Louise’d to death?”

The fictional couple was, of course, featured in a series of television commercials 15 years ago that the insurance industry produced to raise doubts about the big-government nature of the health plan proposed by the Clinton administration. Harry and Louise sat at their kitchen table and criticized the plan as one that would be run by bureaucrats who would get to make health plan choices for ordinary Americans. The message was: “When they choose, we lose.”

Today, Harry and Louise are given credit — or blame, depending on one’s perspective — for having killed the Clinton initiative, and the episode sealed the insurance industry’s reputation as a powerful, unified force that used its might to gain political advantage and maximize profits.

Looking back, there is little doubt that the insurers’ lobbying campaign and the ads that accompanied it played an important role in solidifying public opinion against the Clinton effort. But the widely accepted narrative — unified industry unilaterally slays the health care effort, then reverses itself years later to emerge as savior — misses some of the twists in the debate.

“There is the simplistic, straight story and the nuanced version,” said Dean Rosen, a partner at Mehlman Vogel Castagnetti who was a Senate GOP aide at the time and later worked for the now-defunct organization that ran the ads, the Health Insurance Association of America (HIAA).

Back then, the administration effort fostered fear even before its unveiling, simply because the bill was drafted without input from companies that would have been affected by it or even from some Democrats who wanted to be involved. Divisions among Democrats, in fact, were a key reason the overhaul failed.

It is true that HIAA, along with a number of other interest groups, came out swinging against the 1,342-page Clinton bill. But insurers were never unified in their efforts. There were four trade associations at the time, and they didn’t speak with one voice. One organization that existed both during the Clinton administration and now, the Blue Cross Blue Shield Association, explicitly called for the same types of changes to industry practices that some now consider groundbreaking.

A top lobbyist at HIAA during the Clinton administration, Chip Kahn, said even that group would have accepted the changes being discussed today if the political process had been different.

“If you go back to the 1993-94 debate, there were insurance reforms that HIAA was willing to accept,” said Kahn, now president of the Federation of American Hospitals. Those ideas include the same ones Congress is considering now, he said — rules banning insurers from denying people coverage because of pre-existing conditions or charging sick people higher rates. “If they had been coupled with an employer mandate, HIAA would have accepted those.”

HIAA pulled its Harry and Louise ads in 1994 at the request of Dan Rostenkowski, an Illinois Democrat who was then chairman of the House Ways and Means Committee. Rostenkowski had appealed to the group’s president, former Rep. Bill Gradison, R-Ohio, a moderate who had served with Rostenkowski on Ways and Means. Gradison then opened talks with lawmakers to see if they could reach a deal.

David Abernathy, who was involved in the talks as a top Democratic Ways and Means aide, said that HIAA lobbyists were “amenable to a deal” that would have had many of the same elements discussed today, including a requirement that insurers accept everyone regardless of pre-existing conditions.

Insurers would not have been able to charge people more because of their health conditions, although they could have charged higher rates based on age. In exchange, Congress would have required employers to offer insurance to their workers; this would have guaranteed that insurers would have a broader population among which to spread costs. Today, the potential deal would be sweeter for insurers, because individuals also would be required to buy coverage.