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Health Insurance Industry Looks to Senior Lobbyists

By Jeffrey H. Birnbaum
Tuesday, September 18, 2007

If the rumor mill is correct, Karen M. Ignagni is about to notch a major victory for her employer, the nation's health insurance industry.

As chief executive of the awkwardly named America's Health Insurance Plans, Ignagni presides over the association that represents nearly 1,300 companies that sell health insurance. In that capacity, she has been fighting a rear-guard action in Congress this year to defeat a cutback in Medicare.

On Aug. 1, the House voted to take a five-year, $50 billion bite out of Medicare Advantage, a health plan for seniors that Ignagni's members help run. The next day, the Senate passed companion legislation, but it did not take a dime out of Medicare Advantage.

Now, Capitol Hill is abuzz that the House might soon bow to the Senate and largely if not completely spare the program from cuts -- at least for now. If that happens, Ignagni's member companies stand to profit handsomely and millions of seniors will continue to benefit from Medicare Advantage.

Ignagni will assert (and I expect the phone call any minute now) that she was not responsible for any victory. She will say that it was senior citizens who made all the difference. And to a large extent, she is correct.

But she is also complicit. Ignagni's group, with the help of its members, has been building a list of senior citizen activists since 1999. Known as the Coalition for Medicare Choices, the network is managed by association employees who regularly keep in touch with the seniors who sign up and spur them to action when they are needed.

The network is currently 400,000 strong. In recent months, every senator and nearly 100 congressmen were contacted by multiple seniors in the system. Over the August recess alone, the association clocked about 20,000 calls to congressional offices.

Ignagni supplemented this deluge with a national advertising campaign. Its targeted TV commercials were designed to thank some lawmakers for supporting the industry's position and to remind others who are on the fence that seniors would not be happy if Medicare Advantage were trimmed.

The association also bought newspaper ads to praise the overall legislation, which at its heart expands the popular State Children's Health Insurance Program, or SCHIP. The ad pointedly recommended the Senate's version, which pays for the SCHIP expansion with an increase in tobacco taxes, not a cut in Medicare Advantage.

The effect has been impressive. Congressional aides say they have heard the association's point of view even above the din created by two of Washington's most powerful interests: the American Medical Association and AARP.

AARP, which represents nearly 39 million older Americans, and the AMA, the nation's largest physicians group, joined forces in July to push the House version of the bill. AARP prefers the House bill because it enhances certain aspects of Medicare (other than Medicare Advantage), especially for low-income seniors. The AMA is happy with the House rendition because it blocks a scheduled reduction in Medicare payments to doctors.

Both provisions could well come back later this year -- paid for by shaving Medicare Advantage -- because many lawmakers believe that Medicare Advantage is too rich a program. But for now Ignagni's outpouring of outrage appears to have won the day.

Ignagni, 53, learned the power of grass-roots lobbying when she worked, of all places, at the AFL-CIO for 11 years. She left the labor federation in 1993 to join a predecessor to America's Health Insurance Plans, the American Association of Health Plans.

Labor unions "are the masters of grass-roots campaigns," she said. "I learned a great deal from people who do this very well."

Fire of the Week

The National Association of Attorneys General (NAAG) last week fired its longtime executive director, Lynne M. Ross, and ignited, well, a firestorm.

Ross declined to comment, and the organization said only that it wanted "a new direction." But several current and former attorneys general said the dismissal was a terrible idea and lacked, of all things, due process.

Utah Attorney General Mark Shurtleff (R) called the termination "ridiculous." Pennsylvania Attorney General Tom Corbett (R) said Ross's work for the organization had been "without equal." And former Connecticut attorney general Clarine Nardi Riddle (D), who is now chief of staff to Sen. Joseph I. Lieberman (I-Conn.), said of Ross: "Her life was meeting the concerns of NAAG members and the association. I do hope the entire NAAG board reviews the process that brought this about."

Ross, 60, first joined NAAG in 1976, taking a four-year break during the Clinton administration to lobby for the Environmental Protection Agency. She returned to the group in 1997 as deputy director and became executive director in 2000. According to e-mails that flew among her supporters last week, Ross was given a new four-year contract last year after a thorough management review.

Nonetheless, a delegation of three attorneys general asked Ross to resign on Sept. 7; she refused, saying that she had been unaware of any problems she might be having with her performance. "I do not get the sense that there is broad membership support for terminating my employment and, without details of any performance failures, I am not prepared to resign," Ross wrote in a letter circulated among NAAG members.

Ross's contract was terminated by an 8 to 4 vote of NAAG's executive committee after what participants described as a contentious, nearly two-hour conference call last Wednesday. During the call, Ross's detractors cited what they said was her inability to manage her staff as a reason for her firing.

"There are a lot of people unhappy with this," said one attorney general who spoke on the condition of anonymity because of the sensitivity of the situation. Slade Gorton, the former Republican senator and attorney general from Washington state, said of Ross in an e-mail to colleagues, "For me, she is NAAG."

Hire of the Week

Tony Blankley is leaving as the editorial page editor of the Washington Times to become an executive vice president of Edelman, the public relations firm.

But don't expect the former Newt Gingrich spokesman -- and former Ronald Reagan speechwriter -- to disappear from public view as he counsels the firm's clients worldwide. In this age of blurred journalistic lines, Blankley, 59, said he will continue to write his syndicated column and will also continue to appear on the political yell-fest "The McLaughlin Group."

Oh and one more. The London-born Blankley, who was a childhood actor in Hollywood (including on "Lassie" and "Sky King"), will serve as a visiting fellow at the conservative Heritage Foundation. Maybe he can be elected to Congress as well.

Please send e-mail tokstreet@washpost.com.

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