Within months of arriving in Washington, D.C., Fletcher was selected as the leadership liaison for the 17-member freshman class of Republican legislators. He was appointed to the Committee on Education and Workforce, and John Boehner, chair of the committee's employer/employee relations subcommittee, chose Fletcher as his vice-chair. The committee's purpose is to oversee the rules for employer-paid health plans, among other issues, and although it is rare for a freshman legislator to attain a committee leadership post, Boehner cited Fletcher's experience in the medical field and work on reforming the Kentucky health care system as reasons for the appointment. Fletcher also served as a member of the House Committees on the Budget and Agriculture. In June 1999, he sponsored an amendment to a youth violence bill that allowed school districts to use federal funds to develop curricula which included elements designed to promote and enhance students' moral character; the amendment passed 422–1. Later, Fletcher was assigned to the Committee on Energy and Commerce and was selected as chairman of the Policy Subcommittee on Health.