 During the Obama Administration's 2009–2010 health reform initiative, Kahn, as President and CEO of the Federation of American Hospitals, worked with leaders of the American Hospital Association and the Catholic Health Association of the United States in creating a hospital industry agreement with congressional leaders and the administration.The agreement played a role in the passage and enactment of the Patient Protection and Affordable Care Act of 2010 (42 USC 18001).During the Clinton administration's 1993–1994 health reform initiative, Kahn was responsible for the Health Insurance Association of America’s "Harry and Louise" $14–20 million advertising/public affairs campaign, which influenced the national debate by opposing President Clinton’s healthcare proposal.