The Establishment Is Gearing Up Against Even a Public Option

Tax records we've reviewed show a health care industry front group run by a former Hillary Clinton aide has already amassed millions to block a public health insurance option. Even small reform isn't possible without confronting powerful interests.

Joe Biden speaks while flanked by Kamala Harris at the Queen Theater on November 5, 2020 in Wilmington, Delaware. (Drew Angerer / Getty Images)

The health care industry coalition that aired television ads vilifying Medicare for All during the presidential campaign is gearing up to block a promised public health insurance option — and is already calling on President-elect Joe Biden’s top health nominee to focus on fortifying the current private insurance–based health insurance system, despite his longtime support for Medicare for All.

On Monday, after Biden said he would nominate Medicare for All supporter Xavier Becerra as his health secretary, the Partnership for America’s Health Care Future (PAHCF) issued a statement saying they “look forward to working with the Department of Health and Human Services under the new administration to build on and improve what’s working, where private coverage, Medicare and Medicaid work together to expand access to coverage and care, and fix what’s broken.”

PAHCF’s members include top lobbying groups representing health insurers, drugmakers, and for-profit hospital conglomerates. Under the existing system that the group is defending, up to twelve million Americans have lost their medical coverage during the COVID-19 pandemic, as health insurance industry profits have skyrocketed because people have avoided elective medical procedures.

Now, new financial disclosures reviewed by the Daily Poster shed light on just how much money PAHCF has been able to amass in its crusade to block significant health care reforms. In 2019, the group raised more than $55 million and spent roughly $20 million, ending the year with $36 million in assets, according to its tax return filed with the IRS last month.

Pretending Millions Have Not Lost Their Health Insurance

PAHCF is led by a former top Hillary Clinton aide and operated out of the offices of Forbes Tate Partners, a DC lobbying firm run by former top Democratic staffers on Capitol Hill.

During the 2020 Democratic presidential primary campaign, PAHCF spent $4.5 million on television ads attacking Medicare for All, and it also spent millions this year to block a state level public option plan in Colorado.

President-elect Joe Biden campaigned in support of a public health insurance option to compete with health insurers, and his new HHS pick Becerra backed a public option when he served on the House Ways and Means Committee that considered such a proposal during Democratic health care reform efforts in 2009.

Back then, Becerra declared: “It would be difficult for me to believe that you could have meaningful reform of the system that will bring prices down and help provide coverage for all Americans who don’t have it unless you have the options out there that really would create that competition.”

Any movement on a public option will likely hinge on which party controls the Senate after the two runoff races in Georgia in January. Democrats need to win both in order to take back the chamber.

Nevertheless, PACHF is already redoubling its effort to demonize a public health insurance option.

The organization recently touted a deceptive poll aiming to derail any public option movement. It said its poll found that “78 percent of voters with health insurance coverage are satisfied with their coverage.”

Tens of millions of Americans are uninsured or underinsured, and millions of Americans have lost their insurance during the pandemic.

PAHCF Tax Returns Detail Millions of Dollars of Spending

PAHCF has succeeded in shrouding its agenda in an innocuous name — but behind its gauzy platitudes and cheery brand are millions of dollars from the country’s most powerful corporate lobbying groups.

According to its 2019 tax return, PAHCF’s board of directors included executives at America’s Health Insurance Plans (AHIP), a top DC lobbying group for health insurers; Pharmaceutical and Research Manufacturers of America (PhRMA), Washington’s biggest drug lobby; and the Federation of American Hospitals, which lobbies for investor-owned hospital companies. 

OpenSecrets reported yesterday that PhRMA raised a staggering $527 million last year.

In 2019, when PAHCF was focusing most of its fire on Medicare for All, most of its $20 million in spending went toward attempts to influence public opinion, but it only reported to Congress that it spent $60,000 on federal lobbying efforts.

The organization’s tax return for that year says it spent $18.4 million on lobbying. Why the difference? The IRS form line for lobbying includes both direct lobbying and grassroots lobbying. The IRS defines grassroots lobbying as “any attempt to influence any legislation through an attempt to affect the opinions of the general public or any part of the general public.”

Last December, the Washington Post reported that lobbyists for PAHCF helped write op-eds by two Montana state lawmakers and one Ohio state senator bashing Medicare for All and scaremongering about government-run health care. That’s an example of grassroots lobbying.

While PAHCF doesn’t disclose how much its members donate, it reported receiving six contributions of $5 million, and more than a dozen seven-figure gifts overall.

Investor-owned hospital chain Tenet Healthcare has reported contributing more than $2.1 million to the coalition, including $1.5 million in the first half of 2020.