Originally created 11/28/98

Opponents of managed care overhaul spend $60 million



WASHINGTON -- Insurance companies and their allies in the fight against new regulations for managed health care spent an average $112,000 per lawmaker to lobby Congress in the first half of this year.

The $60 million lobbying outlay was four times the $14 million-plus spent by medical organizations, trial lawyers, unions and consumer groups to press for passage of the so-called Patients Bill of Rights, disclosure reports filed with the secretary of the Senate show.

Not all of the money went for lobbying on managed care, because many groups opposed to the changes also talked to members of Congress about other issues. Lobbying reports do not break down spending by issue.

The $60 million lobbying tab is enough to pay salaries of everyone in the U.S. transportation secretary's office or finance for almost two months the childhood immunization program of the Center for Disease Control and Prevention. It's 50 percent higher than the $40 million that tobacco interests spent between January and June to kill legislation to raise cigarette taxes to curb teen-age smoking.

The figure does not include $11 million spent on advertising against the managed care legislation, nor millions of dollars in campaign contributions that opponents of new regulation made in the just-concluded congressional campaigns.

"It certainly does show that the industry spared little effort to try to defeat patients' rights that are so popular all across the country," said Ron Pollack, executive director of Families USA, a health-care advocacy group.

Dan Danner, chairman of the anti-regulation Health Benefits Coalition, said the money was well spent.

"We didn't have legislation pass in the last Congress, and that was our objective," said Danner, also vice president of federal relations for the National Federation of Independent Business, the small-business lobbying group.

The proposed regulations, which would govern health plans known as managed care or health maintenance organizations, are supposed to give patients more power to challenge decisions about their care.

Opponents said the restrictions would push the cost of health insurance plans so high that small businesses could no longer afford to insure their workers.

They rolled out big guns to argue against the legislation, including Haley Barbour, former chairman of the Republican National Committee; Kenneth Duberstein, White House chief of staff under President Reagan; and Daniel Meyer, former chief of staff for outgoing House Speaker Newt Gingrich.

"They're high-paid lobbyists walking the halls of Capitol Hill, getting access to members in order to make their pitch on managed care reform," said Jim Manley, a spokesman for Sen. Edward M. Kennedy, D-Mass., a leading proponent of the legislation.

While most of the organizations supporting and opposing new managed-care regulation had other issues on their plates, all listed managed-care rules as a priority.

The U.S. Chamber of Commerce spent more money lobbying than any other group in the health-care debate, $8 million.

"That's not just health care, it's environmental issues, it's labor policy, it's tax policy, it's work force training issues, and it's health-care policy," chamber spokesman Frank Coleman said. "Stopping trial lawyers and their agenda of allowing patients of HMOs to sue the companies that provide them the health care was a chamber top priority."

Both the chamber and the small business federation were with the Health Benefits Coalition, as were the Blue Cross-Blue Shield Association, the Health Insurance Association of America and the HMO trade group the American Association of Health Plans.

On the other side, the American Medical Association spent $8.3 million on lobbying during the first half of 1998, the AFL-CIO $1.4 million and the Association of Trial Lawyers of America $940,000.

In addition, several groups of health specialties, including the American Chiropractic Association, American College of Emergency Physicians and American Association of Nurse Anesthetists, formed their own pro-reform coalition that spent $3.3 million.

Both sides are gearing up to fight the battle again in the 106th Congress. President Clinton and Democratic congressional leaders have said the first order of business should be to pass new HMO regulations, and several Republican lawmakers also support new rules.

Meanwhile, the same coalitions that successfully beat back the legislation are planning strategy for next year. "This will be a large effort once again," the Health Benefits Coalition's Danner said. "The stakes are very high."