Final answer:
Large-scale health care reform was not implemented in the 1990s due to opposition from Americans, political conservatism, and other prioritized issues like free trade agreements and illegal migration.
Step-by-step explanation:
In the 1990s, large-scale health care reform was not implemented due to several factors. One reason was the opposition from many Americans who were against the expansion of the federal government. Additionally, conservatism still held a strong majority in political leadership at all government levels, making it difficult to pass such reforms. Furthermore, other priorities like free trade agreements and challenges of illegal migration took precedence over health care reform.