Blue Cross Blue Shield Pursues Agenda on Many Fronts

The influence strategy of Blue Cross Blue Shield is as complex and multi-faceted as the organization itself.

BCBS provides health insurance to 100 million people through 38 local companies and one national association.

It pursues policy at many levels – in Washington, in the states, in the political arena, in the courts and in the marketplace.

Lobby expenditures

The group’s Washington lobbying tab has topped $20 million for the past three years. It peaked at $23.6 million in 2009, during the debate over the Obama health care plan. Last year, lobbying expenditures were almost $21 million.

The organization employs an army of 131 lobbyists in Washington, including four former members of the House of Representatives:

  • Jim McCrery (R-LA)*
  • Dennis M. Hertel (D-MI)
  • Gerry Sikorski (D-MN)
  • Lewis F. Payne Jr. (D-VA)

* McCrery is one of the First Street 30 top lobbyists in Washington.

In addition to its own lobbying staff, BCBS employs 10 outside firms. Here are the expenditures reported for the first quarter of 2012:

Lobby firm 1Q 2012
Avenue Solutions $80,000
Bockorny Group $30,000
Brown Rudnick $10,000
DLA Piper $40,000
Federal Policy Group $70,000
Groom Law Group $200,000
John Troy $50,000
Ryan MacKinnon $30,000
Strategic Health Care $30,000
Tarplin Downs $100,000


Health care reform still ranks at the top of the list. BCBS is the country’s top contractor for Medicare and Medicaid managed care, and monitors these issues closely in Washington.

As an insurance provider to federal employees, BCBS also lobbies on matters pertaining to the Federal Employee Health Benefit Program. The organization also focuses on state-level regulation and oversight of premium increases.

Among the federal bills lobbied by BCBS in 2011-2012 were:

  • 112 H.R.5 To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system.
  • 112 H.R.371 Health Care Choice Act of 2011
  • 112 H.R. 452 Medicare Decisions Accountability Act of 2011
  • 112 H.R.1206 Access to Professional Health Insurance Act
  • 112 H.R.1213 To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges.
  • 112 H.R.1370 To Repeal the annual fee on Health Insurance Providers Enacted by PPACA
  • 112 H.R.1683 State Flexibility Act
  • 112 H.R. 1946 Preserving our Hometown Pharmacies Act
  • 112 H.R. 2182 Generating Antibiotic Incentives Now Act of 2011
  • 112 H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012
  • 112 H.R. 4209 Patient’s Access to Treatments Act of 2012
  • 112 S. 868 State Flexibility Act

Political activity

BCBS has been designated by the Center for Responsive Politics as a heavy hitter, ranking 32nd among the top political donors from 1989 to 2012.

The national association has a PAC, as do state-level affiliates. At the federal level, the association spent $361,000 in 2011 and $391,000 in 2010.

The Center for Responsive Politics ranks BCBS 32nd among the top political donors from 1989 to 2012.

Its giving during the period was overwhelmingly Republican – with 62 percent going to the GOP and 37 percent to Democrats. Last month, the national organization gave $100,000 to the Republican Governors Association.

State-level campaigns

Political spending is even higher in the states. According to data compiled by the National Institute on Money in State Politics, Blue Cross and its affiliates have contributed $2.6 million to state candidates and committees in 2011-2012.

The big spender during the period was Blue Cross Blue Shield of Florida, which spent nearly $1.8 million. Most of that – almost $1.4 million – went to the state Republican Party. The PAC gave $380,000 to the Florida Democratic Party.

BCBS, like several other corporations, recently withdrew its support for the American Legislative Exchange Council, a conservative that has pushed draft legislation for states. ALEC has come under harsh scrutiny since the shooting death of Trayvon Martin, for its advocacy of stand-your-ground laws.

The courts

BCBS, along with America’s Health Insurance Plans, filed an amicus brief with the U.S. Supreme Court in its review of the Obama health care plan. The groups argued that the universal coverage requirement is inextricably linked to other reforms in the plan, and cannot be severed.

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