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?

Trudy Lieberman is a fellow at the Center for Advancing Health and 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. Follow her on Twitter @Trudy_Lieberman.