It took secrecy to lock out the lobbyists.

The health care bill was drafted behind closed doors by Senate Republican leaders, drawing howls from Democrats who said they were shut out of the process.

Also left outside, however, was the army of health care industry lobbyists who helped draft Obamacare in 2009 and 2010 but didn’t get a say this time.

To government watchdogs, the level of complaints from lobbyists is a sign of progress — the sound of the Washington swamp draining. But the lobbyists, who represent a vast array of interests — including insurance companies, patient advocates and business owners — argue that Americans’ voices aren’t being heard in the backrooms on Capitol Hill.

Dick Woodruff, senior vice president of federal advocacy at the American Cancer Society Cancer Action Network, said nobody from the health care industry had a seat at the table to write the bill.

“I’m not kidding. Nobody,” Mr. Woodruff said.

He said blocking industries and groups that the legislation will affect was “bad for America.”

James Gelfand, a top health care policy lobbyist for the ERISA Industry Committee, which represents large employers, said he was left out too.

“By and large, this was a product that came from leadership and what was their vision for what it ought to be,” he said.

Back in 2009 and 2010, it was a completely different story.

“I was going to Capitol Hill like every day for meetings and discussion groups but I don’t know that that resulted in any changes to the underlying legislation,” said Mr. Gelfand. “I feel like at least people held my hand during 2009.”

Cracking down on lobbying and special interest money was a top campaign promise for President Trump. Much of the billionaire businessman’s appeal was his self-funded presidential campaign that he said made him immune to the influence-peddling in Washington.

He followed through on that promise to “drain the swamp” by imposing a five-year ban on Trump administration officials working as lobbyists and a lifetime ban on lobbying on behalf of foreign governments.

Americans generally distrust lobbyists. A Gallup poll last year found that lobbyists were considered the least trustworthy and ethical out of 22 professions, finishing behind members of Congress in the survey.

Still, the lobbying blackout for the Republican bill to replace Obamacare caught government watchdogs off guard.

It sounded too good to be true for Josh Silver, director of Represent.US, a group that advocates for strict laws restricting lobbyists and special interest money in politics.

“I would very much support the idea of the health care industry being blocked from the process. I’m just telling you I don’t believe it,” he said. “You’d have to be born yesterday to actually think that they haven’t been involved in this process.”

John Dunbar, CEO of the Center for Public Integrity, said he was unaware lobbyists were locked out of the process.

“I was under the impression the usual industry suspects were integral to the drafting of the bill. I wouldn’t be at all surprised, however, if public interest lobbyists were left out,” he said, drawing a distinction between industry groups and advocacy organizations.

Sheila Krumholz, chief administrator at the Center for Responsive Politics, said lobbyists shouldn’t be allowed to write legislation but added that lawmakers should seek input from them as part of gathering a broad spectrum of views.

“I think that is something that really galls Americans that, you know, when a lobbyist has such access and influence that they are allowed to draft the legislation and members submit it,” she said.

“But if you talk to lobbyists, they’ll say, ‘That’s my job,’” said Ms. Krumholz.

Some analysts said stakeholders did get a chance to make their thoughts known, though their involvement was different from the writing of Obamacare.

“This process is a little bit different. Obviously, most of the outside groups are opposing the effort this time,” said Alex Conant, a partner at Firehouse Strategies whose clients include insurers. “That said, the health insurers have been in regular contact with the policymakers on the Hill. They’ve certainly been able to give a lot of their input and, unlike the doctors or the hospitals, have not been reflexively opposed to what the Republicans are trying to do.”

The breadth of the lobbyist shutout has drawn stories in the Los Angeles Times and National Journal Daily.

Former Rep. Henry A. Waxman, a California Democrat who was one of the architects of Obamacare, said Republicans kept out every interest group but the Democrats’ process put health care lobbyists and other stakeholders front and center.

“Republicans have learned if people don’t know what’s in it it makes their job easier to legislate in secrecy,” he told National Journal.

The Obama White House cut deals with broad sections of the health care industry, sometimes not alerting members of Congress until afterward, Mr. Waxman said.

National Journal said there was an upside to the lobbyist deal-making: The groups were prepared to back the bill once it was made public, giving Democrats critical allies in selling it.

Those allies were missing Thursday as Senate Republicans unveiled their draft plan, though the U.S. Chamber of Commerce did issue a statement calling the bill a good compromise.

Mr. Conant said having industry stakeholders on board is critical to the success of whatever plan is approved.

“It only works if people participate,” he said. “The individual market only works if health insurers decide to sell plans on them.”

Democratic strategist Jim Manley, who was a top adviser to then-Senate Majority Leader Harry Reid when Obamacare passed, said there was no comparison to the level of lobbying then and now.

“During the crafting of Obamacare, they were all over the place — not only meeting with White House staff, but the groups had a heavy presence on Capitol Hill, providing background lobbying and other help,” he said. “I’m not seeing any of this this time around.”

He said lobbyists were getting a bum rap.

“It’s easy to demonize lobbyists in this day and age. But if they’re good, they’re providing factual information to the Hill that they can use to try and craft legislation,” said Mr. Manley. “The goal of a good staffer is to disregard the hype and figure out who best reflects the views of constituents in their home states and issues you’re trying to wrestle with.”

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