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Lobbyists took in $7.5m on health bill
Industry boosts spending by third
Lobbyists for hospitals, insurance companies, and other major players in the healthcare industry were paid at least $7.5 million in 2005 as the Legislature took up a major healthcare bill, records show.
Big spenders include
The amount spent on healthcare lobbying in 2005 is up more than a third over 2004 and far outstrips what was spent on another industry -- gambling and casinos -- at the heart of an intense slot machine debate playing out on Beacon Hill. Supporters and opponents of expanding gambling paid about $871,000 in 2005.
Spending on healthcare in 2005 also exceeded by far the $3.5 million in lobbying money devoted last year to utilities and telecommunications issues.
Not all the spending was aimed specifically at influencing the major healthcare bill, but observers say much of it was. Secretary of State William F. Galvin said the increased spending represents a significant increase and is ''reflective of a certain culture that these large institutions are used to seeking their will through hiring people of influence."
''They made sure they were taken care of," Galvin said, adding that lobbying by large institutions is not necessarily wrong so long as the public also benefits. ''I don't know the answer to that yet."
The House and Senate both passed the healthcare bill overwhelmingly yesterday, sending it to Governor Mitt Romney, who is expected to sign the bill, though he may veto some components of it. The House is due to take up a bill today on legalizing slot machines at the state's four racetracks.
The healthcare lobbying figures are inexact, because the amounts spent by some of the biggest companies and organizations are not counted in the same lobbying category each year. (For example, lobbying activity by Blue Cross and Blue Shield of Massachusetts, which has tracked the healthcare debate closely, falls in a different category and is not reflected in the figures.) Also, the amount spent so far this year won't be known for several months.
Nonetheless, the increase in lobbying activity reflects how much is at stake in the state's sweeping new health plan for hospitals, insurers, and other members of the healthcare industry, all of whom have worked hard to shape the unprecedented legislation.
So, did the all the lobbying pay off?
It is clear some of the biggest players got at least part of what they wanted.
The business community, for example, lobbied to eliminate from the final bill a provision that was originally a major part of the House plan: a steep tax on employers that do not extend health benefits to employees.
In the end, House leaders agreed to a more modest $295-per-employee assessment on those businesses. Associated Industries of Massachusetts, which spent $279,000 on lobbying overall last year, was instrumental in the change.
''I think it was a good investment," said Richard C. Lord, the group's president, who called the final bill ''a reasonable compromise."
Lord said that while Associated Industries of Massachusetts did not spend more money on lobbying than it has in the past, it devoted more of its time and resources to healthcare than ever before.
''It's the first time really in 20 years that we've had this comprehensive a discussion about how to expand healthcare access," he said.
The bill provides a potential boon to health plan providers such as Blue Cross-Blue Shield of Massachusetts and Harvard Pilgrim Health Care, each of whom spent six-figure sums on lobbying in 2005. The healthcare bill calls for tens of thousands of uninsured people to purchase new subsidized insurance plans, which means insurers stand to get many new customers. For lower-income people, the state will help pay for private insurance coverage.
Marylou Buyse, president of the Massachusetts Association of Health Plans, acknowledged that the bill will probably mean new customers for its members, but she said that will benefit the public. ''There will be more people in health plans, but I think that's good for consumers," Buyse said.
Buyse said the organization would have devoted the same resources to lobbying on a variety of healthcare issues last year with or without a major plan before the Legislature.
Hospitals, which also spent handsomely on lobbying last year, achieved many of the objectives they sought, including increases in Medicaid rates for medical services, said Ron Hollander, president of the Massachusetts Hospital Association. The hospitals had contended that the current payments were not enough to cover their costs. ''Ask yourself this question: Who else does the state pay less than what it costs to produce a product or service," Hollander said. ''It's not just a matter of fairness. It's also something that puts pressure on the premiums for all the rest of us."
Some critics contend that heavy lobbying by the big healthcare players produced a bill weighted toward their interests. But some of the most ardent advocates for healthcare say they are satisfied that the poor and uninsured are well represented in the final legislation.
''What we take confidence in is there is so much money that the leadership is committing toward healthcare reform," said Philip J. Edmundson, chairman of the Massachusetts Affordable Care Today coalition, or MassACT, which is backing a ballot question this fall that seeks to provide near-universal coverage. ''And that money will equal greater access."
The healthcare bill passed by the Legislature aims to cover 90 percent to 95 percent of the uninsured in phases over three years through the assessment on employers; the new private, no cost, or subsidized health plans; and a requirement that everyone carry a minimum level of health coverage.
Globe correspondents Hailey Heinz and Richard P. Cherecwich contributed to this report. Scott Helman can be reached at shelman@globe.com. 
© Copyright 2006 Globe Newspaper Company.
