Health Care Recap: Interest Group Power

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I noticed this post last week from Matt Yglesias dinging Ezra Klein on the power of interest groups in light of the health care reform debate. Yglesias wrote:

What happened in the health care debate is that interest groups were able to get their way on most key points without needing to seriously attempt to deliver votes in exchange. The AMA is supporting the bill, but it’s not running ads against opponents. Pharmaceutical companies and insurers haven’t dropped out of the ferociously anti-reform Chamber of Commerce. No interest group that I’m aware of is cutting off the flow of funds to Chuck Grassley to punish him for his role in sabotaging health reform. Nobody is hitting Olympia Snowe for her bait-and-switch. I haven’t read a single story about a single Republican being “in trouble” with supporters for his or her opposition to reform.

Now that the bill has passed, it’s pretty easy to say that Yglesias is mostly correct. For-profit industry groups did not need to deliver votes for health care reform, yet they were provided huge concessions in the negotiating stages. Instead of delivering votes these organizations were simply asked to not be destructive and to not oppose the bill. In the case of the pharmaceutical companies, they provided large sums of money for advertising to support the bill, but did little to convince their traditional allies in the Republican Party. In the end, these companies received a huge windfall for little effort on their part and with no need for them to stop aligning with opponents of the legislation. Just look at their campaign contributions.

Consider the pharmaceutical companies, who in cutting a deal with the White House got pretty much all the concessions they wanted. You’d think that they wouldn’t just spend money on running ads in favor of the legislation, but they might distance themselves from the anti-reform crowd. As Yglesias pointed out, they didn’t leave the Chamber of Commerce, an organization that was matching the pharmaceutical companies dollar-by-dollar in ads opposing the legislation. The pharmaceutical companies also didn’t stop sending campaign contributions to members of Congress who were ferocious in their opposition to the bill. The top recipient of pharmaceutical and medical product industry money in Congress during the 2010 cycle is Sen. Richard Burr, Republican of North Carolina. Burr has received $143,319 since the beginning of last year. Other top recipients include Sen. Orrin Hatch ($115,515), Rep. Eric Cantor ($63,000), Rep. Dave Camp ($61,150) and Rep. John Boehner ($60,000). As you might know by now, every Republican voted against the bill in both the Senate and the House. Pharma even gave $70,000 to Rep. Jim Matheson, a Democrat who voted against the bill. The hospitals were more consistent in sending money to supporters of the legislation, but they still continued to contribute to anti-reform lawmakers like Burr ($66,300), Sen. Chuck Grassley ($61,300) and Sen. Richard Shelby ($53,600). (All numbers come from the Center for Responsive Politics.)

More importantly, it’s unlikely that any of these groups will be running advertisements for or against lawmakers in the 201o elections. Pharma ran ads to help get the legislation passed because it helped protect them from deeper cost-cuts that Democrats supported and brought them 32 million new customers. Now that it’s passed, they might make the calculation that fewer Democrats in office might protect them from future reforms that they beat back in this legislative round. Alliances like those between powerful interest groups and those normally viewed as opponents don’t last forever or to the next election cycle even.

The unions, however, certainly demonstrated their muscle as an interest group in Washington with heavy lobbying of lawmakers to support the bill coupled with primary threats across the country. If interest group power were on the wane you couldn’t see it when watching the AFL-CIO, SEIU and AFSCME in action. And these are groups that will be running ads for or against lawmakers.

Interest group power is certainly alive and well. There is no doubt about that. It just appears that the more traditional ways in which groups are asked to support legislation–deliver votes, support candidates in the future–were not used in this legislative battle, except in the case of Labor. An ad hoc coalition of for-profit industry groups was formed to not oppose the bill. If anything this path was chosen because these groups are so powerful that even just neutralizing them left enough wiggle room to get the bill passed. In the process, these groups got more than they could ask for.

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  • David, I’m working on making this all a bit more visual and easier to understand. A future post awaits.

    CB, that’s exactly right.

  • CB

    How about the idea of having a cake and eating it too.

    For example, banks want to be seen as willing to lend while not actually lending. So, they talk to potential borrowers, have them fill out forms, go through procedures but, somehow, the loans just never seems to get approved.

    For pharma to support ads in favor of legislation while at the same time giving money to those who oppose it would make for a positive impression on the ad-watching public, so pharma can say, and appear to be, doing their part for the nation while, in fact, funding the opposition that does the actual voting on the legislation.

    All this has a name: PR

  • Paul,
    Thanks for the summary article.
    I’m very interested in your analysis. I did find the narrative hard to follow, perhaps you could supplement with a table or graph that illustrates your findings, as well.
    -David