Managed Care - October 2008 - (Page 20) In a switch, Democrats benefit from insurer largesse I n the five elections from 1998 to 2006, health plans and other health service organizations leaned heavily in favor of Republican candidates when it came to political contributions. That all changed this year. Red and blue divide The Center for Responsive Politics found $8.3 million in industry UnitedHealthgroup contributions for the 2008 elections — $4.9 million from individuals and $3.4 million from political action committees (PACs) — and 36% Democrats reaped 59 percent of the financial harvest. 64% Back in 2006, when Republicans were fighting a losing battle to maintain their majorities in the House and Senate, the GOP took Blue Cross and Blue Shield 61 percent of the $8.1 million donated by the industry. Republicans reached a high water mark in 2002, when they gained 67 per36% cent of the industry’s donations. 64% William Hoagland at Cigna’s Public Policy Group considers the sudden preference for Democrats a natural one considering the likely increase in Democrats in the Aetna House and Senate after the upcoming election. “I think that health plans recognize that change is in the wind,” 44% he says. “They have to begin to 56% deal more directly with some of the legislative decision makers and that turns out to be Democratic.” Humana Here’s a look at the top five insurers and how they divided their contributions. 43% 57% Democrats Republicans Kaiser Permanente 15% 85% Source: Center for Responsive Politics lack. “People recognize that they can’t simply do what they’ve done in the past. They want to make a virtue out of second choice. I can’t show you a broad agreement, but I can tell you such a process is moving forward and that attitudes in the room among diverse stakeholders are really impressive.” Sometime after the election but before the next president is inaugurated, he says, look for a detailed coalition plan for change. “I think that there is a very high likelihood that meaningful health care reform will be squarely on the agenda beginning in the next Congress.” “We’re part of that group,” says Karen Ignagni, the longtime head of the industry’s chief lobbying group, America’s Health Insurance Plans, which signed off on the new campaign featuring Harry and Louise. “We’ve been meeting and working on this.” Ignagni and Pollack do not spell out all the players and all the possible policy changes they will advocate. Ignagni does say that there is broad consensus among stakeholders about “comparative effectiveness, quality improvement, care coordination, disease management, and information technology.” Those are all issues that are common to both candidates and they are serious proposals for health care. Furthermore, the next president is going to have to address the health care safety net, Ignagni says, along with the “patchwork quilt of programs under Medicaid that no one understands.” This ad hoc group is staying focused on the middle ground, quick to resist any pull toward one political party or the other. The group plans to move quickly, looking to get on the agenda in the first 100 days of a new administration. There are serious issues that confront the country aside from health care, Ignagni quickly agrees, but no one can understate the importance of a coalition approach to health care reform. The economic challenge could help gain support rather than hurt it. “I don’t want to be a Pollyanna,” she says, 20 MANAGED CARE / OCTOBER 2008
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