Who Will Be at the Table? Part X

We finally hear from the business community

During the campaign, Barack Obama promised his cheering crowds that, when he rolled up his sleeves to work on health care, he would “have insurance company representatives and drug company representatives at the table. They just won’t be able to buy every chair.” Now is a good time to look at just what kind of seats special interest groups are having at Obama’s table and what they’re doing to bring the public around to their ways of thinking. This is the tenth of an occasional series of posts that will analyze their activities and how the media are covering them. The entire series is archived here.

It was only a matter of time before we heard from the business community. While the press has focused largely on the insurance industry and its opposition to the public plan option, other oppositional groups have also been hard at work. “The non-insurance business community is going to be in the middle of this,” says Harvard pollster Robert Blendon. “But there’s been very little coverage.” Anyone who thinks that trade groups representing American business are snoozing in their tents is sorely mistaken.

At the National Journal, Bara Vaida has done her homework on business lobbyists and has produced a good, in-depth story explaining what the National Federation of Independent Business (NFIB) is up to. The group, a sometime ally of the insurance industry, doesn’t like a public plan because it represents government intrusion in the private market. Nor does it like the idea of its members being required to offer insurance to their workers. The business community will say reform is going to have “terrible implications” like cutting jobs, and the public will be sympathetic to that, Blendon says.

Big business has similar complaints. In a recent message to its members, the U.S. Chamber of Commerce, as influential a trade group as there is, asked them to “tell Congress to oppose flawed health care proposals.” In particular, the Chamber is upset over a public plan; any requirement that they provide employees with health insurance—the so-called employer mandate; and a minimum benefit package, which is emerging as a sleeper issue.

Reform advocates have hoped that legislation would force insurers to offer minimum benefits, as a protection against the skimpy coverage that is becoming commonplace. The Chamber says that a minimum coverage package, like the one offered through the Federal Employee Health Benefits Program, “will bankrupt employers and workers” and won’t appeal to younger workers. Instead, it’s advocating something like a high-deductible plan that includes preventative care. No surprise here.

Last week, the Chamber sent a letter to Sen. Edward Kennedy and Rep. Michael Enzi, outlining its objections. A public plan, the Chamber said, “must not be included in the legislation,” and “an employer mandate would exacerbate the already difficult situation of employers and workers.” Looks like Blendon is spot-on here. The Chamber also encouraged the committees, chaired by Kennedy and Enzi, to consider other provisions not included in legislative proposals. One would allow people enrolled in federal health programs to take vouchers and use them to buy coverage from private insurers.

On June 17, the Chamber also announced a campaign against the president’s health plan, asking its members to “push back” against Democratic bills emerging on Capitol Hill. Within three days, the Chamber’s member organizations had sent 36,000 letters, e-mails, and faxes to the Senate health and finance committees, expressing their opposition. More will be coming. “It’s just beginning because you ramp up. If done well and done quickly we’re adding some political leverage,” the Chamber’s executive vice president, Bruce Josten, told Bloomberg News.

The Chamber also plans a “sustained national media, education, and grassroots advocacy campaign to defend and advance America’s free enterprise values in the face of rapid government growth and attacks by anti-business activists.” The campaign begins in the fall, right when Congress is supposed to vote on health reform. It’s a safe bet that the Chamber will have health care in mind as it revs up its Free Enterprise Campaign.

The Chamber’s effort is significant. Not only can the group mobilize businesses in every Congressional district, it also has a history of generous Congressional campaign contributions. Over the last ten years, the Chamber has spent more to influence Congress than any other lobbying group. Now that’s clout!

Anyone who underestimates the power of the business community need only look at what happened to the COBRA provisions in the stimulus bill. Remember how the politicos’ rhetoric made the world believe the bill would help distressed workers keep their health insurance? In the end, Congress watered down provisions that would do just that. At one point, a House bill would have allowed people age fifty-five or older who had been at their jobs for ten years or more to stay on COBRA at their own expense until they became eligible for Medicare. That would have provided real protection for a group of folks whose health problems make it difficult to buy insurance.

Employers, however, objected, and the provision didn’t make it into the final bill. Seems they were worried about “administrative burdens.” More important, the increasing medical costs for these older workers would cause premium increases for a company’s entire work force, since all employees would be mixed in the same risk pool. And that, of course, would mean employers would have to pay more. An omen for things to come?

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.