For many interest groups, health-care bill's passage isn't the end

By Dan Eggen
Washington Post Staff Writer
Wednesday, March 24, 2010

Interest groups that spent the past year fighting over President Obama's health-care overhaul are quickly transforming themselves for battle in a new arena, working to sway the law to their benefit while helping the lawmakers who supported them during the bruising legislative debate.

Industry groups and labor unions will focus on attempting to steer implementation of the legislation to their advantage, including the writing of federal rules to govern insurance coverage, requirements for employers and the insurance exchanges created under the law. Many conservative groups that failed in their bid to stop the legislation have shifted their focus to attacking Democrats who backed the overhaul and to supporting efforts by more than a dozen GOP governors to challenge the law in court.

These and other efforts by outside interest groups suggest that the health-care legislation signed into law Tuesday by Obama will probably redirect, rather than end, the furious lobbying efforts that have surrounded the administration's health-care plans. Insurers, drugmakers and other health-care companies have broken records for lobbying expenditures over the past year and show little sign of slowing their activities.

Health-care advocacy groups and other organizations that supported the legislation, meanwhile, plan to spend tens of millions of dollars this year on advertising, town hall meetings and other grass-roots efforts aimed at selling voters on the most popular provisions of the overhaul, including policies that forbid insurance companies from dropping coverage for preexisting conditions and money for seniors to plug a gap in Medicare prescription drug plans.

AARP, the nation's largest seniors group, is launching what it describes as the biggest educational campaign in its history to trumpet the law's benefits to AARP members. The organization will also push for rapid implementation of prescription drug relief for seniors and for formation of a new panel to help set Medicare policies, AARP officials said.

"Our role as an advocate does not stop once a piece of legislation is signed," said Nancy LeaMond, AARP's executive vice president of social impact. "We know that the devil's in the details, and so much of what is actually delivered to our members in this bill is determined at the regulatory level, both at the federal level and in the states."

Another group that supported the overhaul, Health Care for America Now, had initially planned to close up shop after spending $47 million in favor of the legislation. But the group, supported by major unions and a liberal charitable foundation, decided in recent weeks to forge ahead with advertising, rallies and other activities aimed at keeping watch on the law's gradual implementation.

"We had no intention or plans to keep going past a signing ceremony," said Richard Kirsch, the group's national campaign director. "But there's going to be a whole debate and political narrative going on out there, and it's important to have our voices out in that."

The U.S. Chamber of Commerce, which already has announced plans to spend at least $50 million on political races this year, has signaled it will push for business-friendly changes to the legislation when officials begin writing the regulations to implement it. Chamber President Thomas J. Donohue said in a statement this week that the group "will work through all available avenues -- regulatory, legislative, legal and political -- to fix its flaws and minimize its potentially harmful impacts."

For many interest groups, the legislation's passage has intensified efforts to reward friends and punish enemies. On the left, groups such as and Americans United for Change have launched television ads in dozens of districts thanking supportive Democrats or targeting GOP opponents such as Rep. Michele Bachmann (R-Minn.). Groups on both sides of the abortion debate, meanwhile, have announced plans to fund opponents of Rep. Bart Stupak (D-Mich.), whose antiabortion maneuvering in the health-care debate pleased neither side.

Conservative groups, many of which helped organize noisy "tea party" protests in opposition to Obama's plans, also say they have no intention of bowing out. FreedomWorks, Americans for Prosperity and other groups vow to help defeat Democrats during November's midterm elections, while also working to limit or repeal the legislation.

Tim Phillips, head of Americans for Prosperity, which has led anti-overhaul bus tours around the country for the past year, said the House vote in favor of the legislation Sunday "awakened the sleeping giant" of conservatives opposed to Obama's policies. Phillips said more than 300,000 of the group's 1 million members have signed a petition warning Democrats "that their days in Washington are numbered."

FreedomWorks, a Washington-based conservative group headed by former House majority leader Richard K. Armey (R-Tex.), said it has formulated a multi-pronged strategy for the coming year that includes support for legal challenges to the health-care legislation and for Republicans who opposed the law.

President and chief executive Matt Kibbe said FreedomWorks' political-action committee, which has been moribund in recent elections, will spend up to $5 million in 2010 to support GOP candidates. Kibbe said the group also will hold a tax day "tea party" meeting in Washington next month and is planning other rallies and political events later in the year targeting vulnerable Democrats in their home districts.

"We have to take this fight back to all the battleground districts," Kibbe said. "If we do our job, you're going to see a huge turnover in the fall. Our job is to maximize energy and maximize boots on the ground."

One exception to the trend among interest groups is Conservatives for Patients' Rights, an anti-overhaul group founded last year by Rick Scott, a former Columbia/HCA executive who runs a chain of walk-in clinics in Florida. Scott, who used $5 million of his fortune to help bankroll a ubiquitous series of television ads, said in an interview last week that he was mainly opposed to a proposed public insurance option, which was dropped from Democratic plans amid Senate opposition.

"A year ago, they said reform was a done deal and it would include a government insurance plan, but that did not turn out to be the case," Scott said. "That was our biggest focus, and I think we were successful."

© 2010 The Washington Post Company