As the year-long fight over health care reform draws to a close, corporations are once again pouring big money into influencing the debate. The U.S. Chamber of Commerce has already spent $11 million just this month to try and get 27 Democrats who supported the health care bill last year to oppose it. Pharmaceutical companies have bought $12 million worth of advertising to try and defeat the measure. The total amount of money being aimed at swing Democrats during this round of lobbying could total $30 million before week's end. The corporate front group Americans for Prosperity, financed by the billionaire conservative oil man David Koch, has also jumped into the fray, funding an anti-reform ad campaign that cost nearly $1 million. As several on-the-fence Democrats try to sort out their constituents' feelings towards the bill, the lobbying is becoming deafening.

As President Obama moves ahead with health care reform, interest groups on both sides of the issue are again ramping up their lobbying efforts. Robert Zirkelbach of America's Health Insurance Plans, the insurance industry's top lobbying group, said his industry is making "a big effort" to counteract attacks from Obama and other Democrats, who have pointed to hefty premium increases to show why health care reform is needed. "We're working really hard to set the record straight on what's driving health care prices in this country, which is underlying medical costs and not health plans," he said, repeating a statement that contradicts a recent study by Health Care for America Now that found insurers are actually raising premiums twice as fast as their underlying medical costs are rising. Organizing for America, the Democratic National Committee's grassroots arm, launched a campaign encouraging Obama supporters to call in their support for reform to talk-radio stations around the country. Other groups ramping up include the 60 Plus Association, which bought $500,000 worth of television ads targeting 18 centrist House Democrats who voted in favor of reform, the corporate-funded Americans for Prosperity, which purchased $250,000 worth of ads last week, the National Right to Life Committee, MoveOn.org and the pharmaceutical lobby. The only group not joining the lobbying frenzy is AARP, whose chief executive, A. Barry Rand, has promised will "make no new statements, send no new letters, run no new ads about health reform." He asked other groups to do the same. "Let's turn down the volume on the outside noise to that our leaders might actually listen," he said.

The pro-health care reform group Health Care for America Now has released a study (pdf) that contradicts insurance companies' claims that their recent, exorbitant rate hikes were driven by increases in the cost of medical care. The study shows that over the last eight years premiums have almost doubled, while medical inflation only increased by 40 percent. HCAN found that insurance companies are raising their rates more than 20 percent faster than the amount they are paying out to doctors, and twice as fast as their underlying costs of medical care are rising. In short, insurance companies are hiking premium prices much more quickly than their costs are increasing. HCAN also found that insurance companies are spending the extra money on perks. For example, Anthem spent $27 million on 103 executive retreats to locations like Hawaii in 2007 and 2008 alone. From 2000 to 2008, insurance companies spent $716.4 billion of their premium dollars on administrative costs, salaries for their CEOs, and investor profit -- practically enough to fund the entire health reform bill.

By writing the health care reform bill as a budget bill, Senate Democrats could advance the measure using a procedure called "reconciliation," which would avoid a Republican attempt to stall the measure by filibustering it. But Republicans are portraying use of reconciliation -- "Washington-speak" for seeking a simple majority vote -- as scandalously improper for a health reform bill. Senator Bill Frist (R- Tenessee) claimed use of reconciliation would be "unprecedented" and "historic." Scott Brown (R-Massachusetts) erroneously called reconciliation "the nuclear option." John Kyl (R-Arizona) complains that reconciliation "was never designed for a large, comprehensive piece of legislation such as health care," and Orrin Hatch (R- Utah) said "The use of expedited reconciliation process to push through more dramatic changes to a health care bill of such size, scope and magnitude is unprecedented." In reality, use of reconciliation to pass major health reform measures is the norm. Most health care reform measures passed over the last 30 years were passed using reconciliation. The bill that created COBRA, for example -- the law that allows people to keep their health insurance after they leave their jobs -- was passed through reconciliation. ("COBRA" stands for "Consolidated Omnibus Reconciliation Act of 1985," the name of the bill in which it was passed.) Expansion of the Children's Health Insurance Program (CHIP) was also achieved through reconciliation. The process was also used to add protections for nursing home patients, preventive care like cancer screenings, and a hospice benefit to Medicare. In fact, over the last 30 years, far more major health care financing measures have been passed using reconciliation than not.

CMD's Senior Fellow on Health Care, Wendell PotterThe House of Representatives today introduced legislation to repeal an exemption to federal anti-trust laws that the insurance industry, including health insurers, has enjoyed since 1945. The McCarran-Ferguson Act of 1945 gave states the authority to regulate the insurance business without interference from federal regulation, unless federal law expressly provides otherwise. Federal anti-trust laws protect consumers by preventing unfair business practices like price-fixing, bid-rigging, and allocation of markets, and are aimed at helping keep competition honest. House Speaker Nancy Pelosi held a press conference February 23 to announce the "Health Insurance Industry Fair Competition Act," and the Center for Media and Democracy's Senior Fellow on Health Care, Wendell Potter, was invited to speak at the event. Mr. Potter, who worked inside the insurance industry for 20 years, said the exemption for insurers has "contributed to a health care system that has become one of the most dysfunctional and one of the most expensive in the world. And it is time that the health insurance industry begins to abide by the same rules and regulations that every other industry in this country has to abide by." Democrats hope the bill will lower premiums by giving consumers more choices. The White House supports the legislation. The insurance industry's trade group, America's Health Insurance Plans, opposes the measure, saying that their industry is already highly regulated and that mergers and other business practices are already subject to federal anti-trust laws. They also say the law would create "legal uncertainty," which would be bad for the industry. Read Mr. Potter's entire statement in support of the bill here.

Manufacturers of sugar-laden drinks are adopting Big Tobacco's public relations strategies in response to government proposals to tax soda and sugary drinks. They are claiming their products are wholesome or harmless at worst, sowing doubt about whether their products are really related to the problem (even when there is no longer doubt that they are), marketing heavily to children, funding front groups to oppose the taxes, and trying to take attention away from their products by focusing arguments on other topics, like individual responsibility and the totality of the diet. They are also employing spokespeople who are well-versed in tobacco industry strategies. Derek Yach, now senior vice president of global health policy at Pepsico, used to work for the World Health Organization developing the WHO's Tobacco-Free Initiative. Speaking on behalf of Pepsico, Yach applies the tobacco industry strategy of linking the originally-proposed action to a fear-inducing outcome (also known as Philip Morris' "Bigger Monster" strategy): Yach argues that "Simply pricing one product higher would lead to unknown effects on total dietary consumption. It may even lead to worse situations: people may stop spending on one food to eat more of another, so taxing high levels of sugar may lead to eating higher levels of fat."

Trudy Lieberman of the Columbia Journalism Review writes, "Jonathan Gruber is an economist from MIT. Jonathan Oberlander is a political scientist from the University of North Carolina. Both are health policy experts and, from what we can tell, both know their stuff. But the press has counted on Gruber rather than Oberlander to give gravitas to their stories. ...[T]he media relies way too much on the same sources, who utter the same thing again and again to different news outlets. The problem with this, of course, is that a particular view of the world spreads widely, perhaps reinforcing that view as the correct one -- which it may or may not be, depending on the facts and on which side of the river you call home. Gruber has been the cheerleader-in-chief for the Massachusetts health care plan, which is the model for federal reform. He sits on the board of the Connector, the state’s policy brokerage service, and thus has something of a vested interest in positively spinning the reform efforts there. Last year on the PBS NewsHour, he told how premiums for individuals buying their own coverage in Massachusetts had dropped dramatically. But he didn’t mention how premiums for workers in small businesses had risen to sky-high levels in order to make that possible."