Money, politics and policy: health care edition

Matthew DoBias, Health Groups Do Balancing Act With Donations National Journal 10/09/2010

Overall, contributions from trade associations representing doctors, hospitals, and drug manufacturers are all leaning heavily toward Democrats. Yet, while avoiding direct confrontations with their Democratic allies in the health care fight, the groups are tilting toward Republicans in open-seat Senate contests -- signaling that they might be preparing for a post-midterm world in which Republicans will control more of the agenda.

The clear tilt of donations toward incumbent Democrats represents an extension of the handshake deal that the hospital, physician, and pharmaceutical lobbies made with Obama to support his approach to health care reform.

In July 2009, three of the nation's most influential hospital groups, including the American Hospital Association and the Federation of American Hospitals, trumpeted a deal to accept more than $155 billion in Medicare and Medicaid cuts to help finance the reform effort. In return, they agreed to back the Democratic-led effort to reshape the health care industry. That commitment remains apparent -- to a point -- in the way they are distributing their campaign dollars this year.

The wording isn't clear there. It sounds like the industry made a concession, and then out of gratitude for being allowed to make the concession, made another one. It doesn't explain the role of the individual mandate and the public option.

But for each of these groups, this cycle's pattern marks a shift from their traditional approach. [The pharmaceutical lobby] PhRMA has been closely identified with Republicans over the past decade; until earlier this year, it was led by former Rep. Billy Tauzin, R-La. From 2000 through 2006, while Republicans controlled both Congress and the White House, PhRMA directed about three-fourths of its congressional contributions toward Republicans. The Federation of American Hospitals also had leaned strongly to the right, directing nearly two-thirds of its giving toward the GOP. So did the AMA: In each election from 2002 through 2006, it directed at least three-fifths of its contributions to Republicans.

Almost without exception, the groups this year have avoided contributions to Republicans challenging incumbent Democrats who voted for reform. The AMA PAC, for instance, hasn't contributed to any such challenger except Eric Wargotz, a Republican physician who hasn't displayed a pulse in his race against Sen. Barbara Mikulsk of Maryland. And AMA has contributed to her campaign as well.

AHA and PhRMA have also shied away from contributing to Republicans challenging incumbents who voted for the legislation. The four PACs have contributed to a long list of embattled Democratic supporters of the bill, from Sens. Michael Bennet of Colorado and Harry Reid of Nevada to Blanche Lincoln of Arkansas, who held up her vote until the 11th hour before ultimately supporting the package. [my emphasis]

But now that the industry has the individual mandate and the public option is out, it seems pretty clear what the answer to the question posed at the end of the following passage will be:

The broadest measure of health industry support sends a similar message of qualified allegiance. Individual contributors who identify themselves as part of the health care sector have donated close to $321 million to congressional campaigns, according to an analysis by the Center for Responsive Politics. And they have split their donations almost exactly in half between Democrats and Republicans.

For Democrats, this bifurcated pattern of support for incumbents and a tilt to open-seat Republican challengers leaves the largest question unanswered: If a new GOP majority tries to repeal or block the law in 2011, will the industry defend the law or join in the campaign to raze it?

Tags: 2010 elections, health care reform