Hillary Clinton

Hillary Clinton walked into the White House in 1993 with a resume most incoming First Ladies did not have: a Yale Law School degree, a partnership at a major Arkansas law firm, and 12 years as Arkansas's first lady building education reform programs of her own. Bill Clinton gave her an office in the West Wing rather than the traditional East Wing space reserved for presidential spouses, a small but pointed signal of how directly he intended to involve her in policy, and within weeks he appointed her to chair the task force charged with designing his signature legislative priority, national health care reform.

The task force Clinton led met largely behind closed doors, produced a 1,342-page bill, and collapsed in Congress by the fall of 1994 under a combination of industry opposition, Republican resistance, and criticism of the process itself, a defeat that cost Democrats politically for years afterward. She adjusted course rather than retreating, shifting toward narrower, more achievable goals and taking a central role in passing the Children's Health Insurance Program in 1997, which extended coverage to millions of children in families that earned too much for Medicaid but too little to afford private insurance.

Clinton's influence did not end with the White House. She won election as a United States senator from New York in 2000, served as secretary of state under Barack Obama from 2009 to 2013, and became the first woman nominated for president by a major party in 2016, losing the general election to Donald Trump despite winning the national popular vote. Few former First Ladies have built a second career in elected office on anything close to that scale.