Health Plan Payments to Lobbyists Soared in 2007, Could Grow More in 2008

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By Steve Davis
Managing Editor
sdavis@aispub.com

AIS’s Health Business Daily
Featured Story April 11, 2008
Reprinted from HEALTH PLAN WEEK, the industry’s leading source of business, financial and regulatory news of health plans, PPOs and POS plans.

Health insurers collectively paid more money to lobbyists in 2007 than they did a year earlier, according to disclosure forms made available last month by the U.S. Senate’s public records office (see table, below). Much of that money was spent to lobby lawmakers on issues related to Medicare Advantage (MA) and the reauthorization of the State Children’s Health Insurance Program (SCHIP). With both issues still unresolved — combined with the threat of health care reform under a potential Democratic president - industry observers say lobbyists might see even heftier paychecks this year from their health insurance clients.

“The number-one issue for health plans last year was payment under Medicare Advantage,” says Robert Laszewski, president of Health Policy and Strategy Associates, LLC, a policy and marketplace consulting firm based in Alexandria, Va. That issue, along with SCHIP, has been pushed forward and will continue to be a key topic for health plans and their lobbyists in 2008 and 2009, he adds.

Some lawmakers advocated legislation that would have used cuts to the MA program to fund SCHIP and to offset fee cuts to physicians in the Medicare fee-for-service program. While the legislation enacted late last year left MA payment intact, after heavy lobbying by health plans, cuts to the program have been proposed since then.

Although health insurers generally support an expansion to the SCHIP program, they oppose legislation that would cut MA spending to fund it, says Sara Rosenbaum, chair of the Department of Health Policy at the George Washington University School of Public Health and Health Services. Health plans will be spending to lobby in opposition to MA cuts again this year, she predicts.

Health Plans Target Medicare, Medicaid

Several insurers that rely on revenue from Medicare and Medicaid programs significantly boosted their lobbying budgets last year. Centene Corp., for example, spent less than $10,000 on lobbying in 2006, but paid $220,000 in 2007, according to documents filed with the Senate. The reauthorization of SCHIP was the only issue identified in the lobbying report filed by Centene.

WellCare Health Plans, Inc., which spent just $80,000 on lobbying in 2006, quadrupled its spending in 2007 to $320,000. More than half of that, $180,000, was paid to Washington, D.C.-based law firm Hogan & Hartson to lobby on Medicare issues, according to public records. Molina Healthcare, Inc., which paid $660,000 to lobbyists in 2007, said its top lobbying issues were MA, Medicaid funding and SCHIP reauthorization.

Health Plans Paid $22 Million to Lobbyists

HPW analyzed dollars paid to lobbyists by 15 health plan operators in 2006 and in 2007. Collectively, those firms paid more than $22 million in 2007 — up from $18 million in 2006 — to lobby Congress, the White House, CMS, the Congressional Budget Office as well as the departments of HHS, Labor and Transportation, and the National Economic Council.

UnitedHealth Group paid $4.56 million to its lobbyists in 2007 — up from $2.82 million spent a year earlier. Some of United’s top issues, according to its filing, included personal health records, Medicare advertising and genetic information non-discrimination. CIGNA Corp. also nearly doubled its lobbyist spending from $680,000 in 2006 to $1.22 million in 2007. Along with bills tied to MA and SCHIP, CIGNA’s lobbyists targeted a bill to protect health plan enrollees if a national insurer becomes insolvent.

Collectively, the nation’s Blues plans spent $9.8 million on lobbying efforts in 2007, which was a slight increase from the $9.5 million spent a year earlier. About $1.5 million of that was spent by WellPoint, Inc. Along with lobbying on MA funding and SCHIP reauthorization, the insurer also lobbied on issues related to industrial banks. That seems to have been money well spent. In September, the Federal Deposit Insurance Corp. approved WellPoint’s application to open an industrial bank that will be used to administer health accounts such as health savings accounts.

The trade association America’s Health Insurance Plans paid $6.9 million to lobbyists in 2007, which is slightly less than the $7.1 million it spent in 2006. In addition to bills that called for the expansion of SCHIP, AHIP lobbied in favor of legislation that would allow for the marketing of generic biotech drugs, and against MA payment cuts.

Fear of Reform Could Mean More Lobbying

Now that health reform has become a centerpiece of the Democratic presidential candidates’ platforms, 2008 is likely to be a bigger year for health insurance lobbying than 2007 or 2006, says Devon Herrick, senior fellow at the National Center for Policy Analysis. Moreover, both Sen. Barack Obama (D-Ill.) and Sen. Hillary Clinton (D-N.Y) favor guaranteed issue and community rating for health coverage, and both support an employer mandate (i.e., pay or play). And both candidates would work to expand SCHIP, he says.

Although health plans might spend more on lobbying effort in 2008 than they did the previous year, little is expected to be resolved. “We’re really treading water in 2008, but in 2009 the dam breaks loose” when a new president is sworn in, Laszewski says. “George Bush has said he will veto any changes to MA, but I doubt John McCain will be as strong of a defender of that program. And if a Democrat wins the White House, it’s game over” for MA. In 2009, major health reform will be the biggest issue for health insurers.

To access lobbying records, visit http://soprweb.senate.gov/index.cfm?event=choosefields