It’s been a long, long time, and I’m going off memory here, so I’m too lazy to try and search around and dig out the details. If anyone wants to correct, feel free.
I think we need to step back first. At the time Clintoncare was proposed, employer-provided insurance largely functioned along the lines of indemnity insurance. That is, you picked your doctor, the insurer paid their portion without really questioning much about it, and the employer picked up the tab. The other primary insurer model was a managed care model, where the insurer limited costs by having narrow networks and only allowing certain treatments and the like. The managed care model was largely the province of HMOs, which were still fairly limited in their geographical reach, and which basically brought the medical provider network in-house to control costs.
Since the Clintoncare proposal, though, most employers have moved away from the indemnity insurance model to the managed care model, and PPOs (which are a type of managed care) have become wide-spread.
This leads us to the biggie difference. Clintoncare would have essentially forced everyone into a managed-care model. Obamacare doesn’t have to do that, since pretty much everyone is now already on a manged-cared model.
Clintoncare was also more aggresive in setting actual prices, whereas Obamacare relies on the managed-care model to control costs in the non-Medicaid sector.
Clintoncare also did not have state-based exchanges. Instead, everyone would be grouped into co-ops that would use their purchasing power to negotiate. In practice, I think this would have largely ended up looking like the Obamacare exchanges, but it wouldn’t have necessarily been state-based. Also, in Obamacare, employers don’t have to participate in the exchanges (small employers can voluntarily particulate). Whereas in Clintoncare, all employers would have been required to become part of a co-op.
Obamacare also has a grab-bag of ideas that economists have proposed to control costs in the health care sector (like bundled payments and medical provider co-ops). I don’t know how much of these things were present in Clintoncare, so someone will have to fill in the details on that.
But, as you said, there are a lot of similarities.