The New York Times reports that there are three Democratic senators who are viewed as holdouts on a procedural vote to go forward with debate on the final Senate health care reform bill. The senators are most conservative members of the Democratic caucus and represent states that largely voted for Republicans in both the 2004 and 2008 presidential races. They also are all top recipients of campaign contributions from the health insurance industry and have former staffers working for the industry.

From 2005 to 2009, Sen. Blanche Lincoln has received $139,149 from the health insurers and HMOs. The majority of that money comes from Blue Cross Blue Shield, the health insurance provider that holds a 75 percent market share in the senator’s home state of Arkansas. Blue Cross Blue Shield has contributed over $80,ooo to Sen. Lincoln since the 2006 election cycle.

Elizabeth Barnett, Sen. Lincoln’s former health advisor, left the senator’s office in 2007 to work as Blue Cross Blue Shield’s top Democratic lobbyist. Earlier this year, Barnett left Blue Cross to work for Avenue Solutions, where she retains Blue Cross Blue Shield as a client. Avenue Solutions’ profile of Barnett notes that she “had primary responsibility for representing [Blue Cross Blue Shield] and its 39 member plans before the Senate Finance Committee, Senate Democratic Leadership, and other key Senate committees and offices.” Barnett also represents the two other major health insurers UnitedHealth Group and Aetna.

(You can see a visualization of Sen. Lincoln’s connections to health care companies through her former staffers turned lobbyists here. This was created for a previous post on Sen. Lincoln.)

In 2005, Sen. Lincoln’s chief of staff Kelly Bingel left to work for Mehlman Vogel Castagnetti Inc. with a lobbying portfolio that includes over a dozen clients invested in health care reform. Bingel represents a who’s who of the health care industry including America’s Health Insurance Plans (AHIP) and Pharmaceutical Researchers & Manufacturers of America (PhRMA). While AHIP previously refused to take sides in the health care debate, in the past few months the health insurers group has voiced a full-throated opposition to the public option and has taken on the administration and Congress over the overall bill. PhRMA, on the hand, received a sweetheart deal that was crafted by Sen. Max Baucus and the White House that won their support of the entire bill.

Sen. Ben Nelson of Nebraska is third Democratic holdout. Since the 2006 election cycle, Sen. Nelson has received $91,200 from health insurers and HMOs. Like Sen. Lincoln, the majority of that money comes from Blue Cross Blue Shield with $65,550 coming from the largest health insurance provider in the senator’s state.

Sen. Nelson’s former legislative director Amy Terjal left his office in 2007 to work as a lobbyist at Avenue Solutions, the same firm as Barnett. Terjal holds the same clients as Barnett. Three of the top health insurers in the nation — Blue Cross Blue Shield, UnitedHealth Group and Aetna — are clients of Terjal’s.

Another Democratic holdout, Louisiana’s Sen. Mary Landrieu received $104,548 from health insurers and HMOs since the 2006 election cycle. Sen. Landrieu’s long time chief of staff Jason Matthews (1996-2009) left her office this year to work as director of congressional affairs for the U.S. Chamber of Commerce. The Chamber is a staunch opponent of health care reform recently commissioning a study to prove that the stated health care reforms being considered in Congress would have a negative economic impact.

Health insurers had remained on the sidelines of the health care reform debate until recently. In October, AHIP released a study that claimed to show the cost of health insurance plans rising in the years following the enactment of reform. Since then, the organization has begun running television commercials in at least 10 states threatening seniors that their benefits will be cut under the reforms under consideration in Washington.

Earlier today, Majority Leader Harry Reid held a closed door meeting with these three senators to assuage their concerns and court their vote on cloture for the health reform bill. Sen. Nelson released a statement that appears to show support for voting in favor of cloture on the bill, “Why would you stop senators from doing the job they’re elected to do — debate, consider amendments, and take action on an issue affecting every American?”