cooperation and the wisdom of taking small steps to get a big job done." Again in 2007, she reflected on her role in 1993–1994: "I think that both the process and the plan were flawed. We were trying to do something that was very hard to do, and we made a lot of mistakes." She received hundreds of thousands of dollars in campaign contributions from doctors, hospitals, drug companies, and insurance companies for her 2006 re-election in the Senate, including several insurance companies that were members of the Health Insurance Association of America that helped defeat the Clinton Health Plan in 1994. Charles N. Kahn III, a Republican who was executive vice president of the Health Insurance Association in 1993 and 1994, refers to his previous battles with Clinton as "ancient history", and says "she is extremely knowledgeable about health care and has become a Congressional leader on the issue." Until the Affordable Healthcare for America Act, a combination of factors kept health care off the top of the agenda. For example, politicians were not eager to confront the forces that successfully frustrated the Clinton effort, health maintenance organizations were able to limit cost increases to some extent, and a conservative Republican majority in Congress or a conservative Republican president was in power or in office. The Clinton health care plan remains the most prominent national proposal associated with Hillary Clinton and may have influenced her prospects in the 2008 presidential election. There are some similarities between Clinton's plan and Republican Mitt Romney's health care plan, which has been implemented in Massachusetts, though Romney has since distanced himself from Clinton on the issue, in particular arguing that his plan calls for more control at the state level and the private market, not from the federal government. In September 2007, former Clinton Administration senior health policy advisor Paul Starr published an article, "The Hillarycare Mythology", and he wrote that Bill, not Hillary, Clinton, was the driving force behind the plan at all stages of its origination and development; the task force headed by her quickly became useless and was not the primary force behind formulating the proposed policy; and "[n]ot only did the fiction of Hillary's personal responsibility for the health plan fail to protect the president at the time, it has also now come back to haunt her in her own quest for the presidency." See also Health Security Express