What do AT&T, Blue Cross/Blue Shield, the Teamsters Union, U.S. Steel, Lowe’s, the NAACP, the Colorado Farm Bureau and the City of St. Louis all have in common?

Give up? They’re part of the motley crew of fewer than three-dozen entities that reported lobbying specifically on the “public option” last year.

Despite the energy and resources that have poured into the public option debate, few players actually detailed their lobbying on this high-stakes proposal, the Center for Responsive Politics has found.

Reporting requirements for lobbying activity allow for broad and ambiguous descriptions of actual lobbying activity. Organizations are required to disclose lobbying on broad, general issues (such as “health issues“), as part of the filing procedures associated with the LD-2 lobbying reports.

A secondary, “specific issue” field is designed as a place for lobbyists to identify the bill number, bill title and other additional information about their specific causes. However, the amount of additional information detailed in this field can vary.

A Center for Responsive Politics review of 2009 lobbying reports filed with the Senate Office of Public Records shows just 30 clients reference the phrase “public option” in the specific issue field. Anecdotally, many other corporations and organizations lobbied on the public option issue, but without specifically stating that they did in these filings. They may also have used words or phrases other than “public option” to describe this advocacy for or against the controversial proposal.

In this snapshot that examined only records that explicitly used the phrase “public option,” the Center for Responsive Politics found a broad range of disclosure levels.

Records for the League of Women Voters, for instance, clearly identify the group as favoring the plan. The same is true for the NAACP — for whom records detail support of a “choice of a private (allowing recipients to stay with their existing health care coverage if they choose) or public health care plan, which includes a new public health care plan (the public option) that will provide a guaranteed backup which will always be there to ensure quality, affordable health care coverage no matter what.”

On the other end of the spectrum, some clients were not shy about specifying their opposition.

“Advocated in favor of non-profit, non-governmental co-op and oppose other public options proposals including the opt-out proposals,” states one report from the American Hospital Association.

And reports for the Center for Individual Freedom detail “Research/preparation for meetings and correspondence with House and Senate staff in opposition to [comprehensive] health care “reform,” to any government-run public option, tax increases and various other proposals under consideration.”

Yet a large proportion of records yield few clues about the clients’ positions on the proposal.

Client Position Detailed Specific Issue Detail Examples AIDS Action Council Support …support inclusion of […] public option in health care plans… American Hospital Assn Oppose …opposed proposal to expand Medicare under the public option… Advocated in favor of non-profit, non-governmental co-op and oppose other public options proposals including the opt-out proposals… American Public Health Association Support …support a “public option” as a insurance choice in health reform proposals… AT&T Inc Unclear …HR 3200 America’s Affordable Health Choices Act of 2009, as it relates to ERISA, public plan option… Blue Cross/Blue Shield Unclear …issues pertaining to the excise tax, public option… Center for American Progress Unclear … H.R. 3962 – Affordable Health Care for America Act; public option… Center for Individual Freedom Oppose … Research/Preparation for meetings & correspondence with House and Senate staff in opposition to comprensive [sic] health care “reform”, to any government-run public option… City of St Louis, MO Unclear … H.R. 3590 – Senate Healthcare Reform bill – issue of public option… Colorado Farm Bureau Oppose …oppose all provisions relating to a ‘public option’ or ‘government-run’ health care… Common Cause Support …supported a public option being included in health care legislation… Corporate Health Care Coalition Unclear …HR 3590 Patient Protection and Affordable Care Act … Public Option… Iowa Hospital Assn Unclear …Health care reform legislation, including […] public option … Kimberly-Clark Corp Oppose … HR3200/HR3962: Health Care Overhaul — Public Option – Oppose… League of Women Voters of the US Support …support passage of comprehensive health care reform legislation, including a public option… Lowe’s Companies Unclear … House and Senate health care legislation re 90 day autoenrollments, ERISA preemptions, long term care insurance fees, public option, and other measures considered in health care reform… Marshfield Clinic Oppose …opposition to the establishment of a public option in Health Insurance Exchanges if it were to reimburse providers at Medicare rates… National Advocacy Center of the Sisters of the Good Shepherd Support …support a robust public option in health care reform legislation… NAACP Support …create a public option to increase competition among health insurers… Support the inclusion of a public option in health care reform… National Association Management Group Unclear …H.R. 3200 – America’s Affordable Health Choices Act of 2009 (and related Health Care bills) – regarding the creation of a comprehensive health care system that includes employer mandates and a public option… National Auto Dealers Assn Unclear …H.R. 3962, “Affordable Health Care for America Act”, employer mandate, public option, and surtax provisions… Natl Alliance of State Rural Water Assns Support …America’s Affordable Health Choices Act (HR 3200) – support for Medicaid expansion, public option, prevention and public health infrastructure… New England Council Unclear …healthcare reform – analysis of public option… National Right to Life Committee Unclear …contacts in support of Enzi Amendment 285 to prohibit the Secretary of Health and Human Services from limiting access to end of life care by allowing the public option to employ a pattern or practice of discrimination based on the age, disability or purported “quality of life” of the patient… Small Business/Entrepreneurship Council Oppose …opposed employer mandates, “play-or-pay”, increased taxes (surtaxes, for example), a public option for health coverage, and excessive bureaucracy and spending in health care reform… SSM Health Care Oppose …opposed public options that would cause employers and individuals to shift from private coverage to public coverage… Teamsters Union Unclear …American Healthy Future Act; taxation of employer provided health care benefits; “insurer excise tax”; employer mandate, “play or pay” proposals, public option issue… Traditional Values Coalition Oppose …letter to Senators opposing a government-run, public option to national healthcare… UnitedHealth Group Unclear …the Affordable Health Choices Act-Medicare Advantage-Medicare Part D-Medicaid Managed Care -Cost containment-Public Option… US Pharmacopeial Convention Unclear …HR 3200, “America’s Affordable health Choice Act of 2009”, regarding the amendment on public option/ formularies… US Steel Unclear …H.R.3692, Affordable Health Care for America Act Regarding the following issues: […] Public Option…

The “public option” rose to center stage in last year’s health care reform debates. It was envisioned to serve as a government-backed insurance option to give private insurers further competition and keep costs down.

President Barack Obama had campaigned on a public insurance option in his 2008 presidential bid. Most Democrats also supported the idea, and most Republicans, meanwhile, railed against it. Major drug companies, insurers and their trade associations also vocally opposed its creation, while major unions embraced it and lobbied for it.

House Democrats included the proposal in the comprehensive health insurance reform bill that they passed in November. Several moderate and conservative members of the Democratic caucus in the Senate, however, objected to its inclusion in that chamber’s version of health care reform legislation, and no such measure was part of the bill Senate Democrats passed in December. (In September, the Senate Finance Committee rejected two amendments that would have created a public option when it drafted its plan.)

The public option passed by the House would be available as part of a newly created national insurance exchange for employees of small businesses, self-employed people and unemployed people not already receiving assistance through programs like Medicare.

The public option has recently returned to the political limelight after freshman Sen. Michael Bennet (D-Colo.) led his colleagues in urging Senate leadership to pass a public health insurance option via reconciliation — a procedural rule that allows budgetary measures to pass with a majority of senators. This avoids a cloture vote, which requires a three-fifths majority to end debate on an issue.

More than 20 Democratic senators have since signed this letter to the leadership, and more than 100 members of the House have signed a similar letter there circulated by fellow Centennial State freshman Rep. Jared Polis (D-Colo.).

White House vote counters have long been skeptical that the public option would garner enough votes to pass in the Senate, and Obama did not include the idea among his proposal released ahead of Thursday’s bipartisan health care summit.

Nonetheless, lobbying and debate on the public option is likely to continue as long as Democrats are discussing health insurance reform plans.

CRP researcher Matthias Jaime contributed to this report.



For permission to reprint for commercial uses, such as textbooks, contact the Center: Feel free to distribute or cite this material, but please credit the Center for Responsive Politics.For permission to reprint for commercial uses, such as textbooks, contact the Center: [email protected]

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