WASHINGTON — On a recent Wednesday morning, 1,000 insurance brokers spread out across Capitol Hill with a singular mission: kill a proposed government-run health care plan.
Among them was J. Hyatt Brown, former Florida House speaker and board chairman of Brown & Brown Inc., a national brokerage firm based in Daytona Beach and Tampa.
In a private meeting with his local congresswoman, Rep. Suzanne Kosmas of New Smyrna Beach, Brown pressed the case. "The federal government only does one thing better than private enterprise," he told her, "and that's war."
Brown is not just talking. He and others at his firm gave Kosmas $20,000 in campaign contributions during a three-month span this year.
The health care debate has triggered a surge in campaign cash since reform emerged as a dominant theme in the 2008 elections. The push has intensified this summer as powerful industry groups try to shape the legislation.
And now it seems likely the public insurance option will not survive, in part due to reluctant Democrats like Kosmas and Florida Sen. Bill Nelson and nearly universal opposition from Republicans. During a town hall meeting Saturday in Grand Junction, Colo., President Barack Obama played down the necessity of a public option in the final bill.
Florida lawmakers received $813,000 in the first six months of this year from health insurance and medical interests, according to a St. Petersburg Times analysis, up about $315,000 from the same period in 2008.
Of that, $305,000 has come directly from political action committees controlled by AFLAC, Humana, Pfizer and powerful lobbying groups such as the American Health Care Association.
Republican Rep. Ginny Brown-Waite of Brooksville has seen a $17,000 increase from drugmakers and insurers. Rep. Gus Bilirakis, R-Palm Harbor, has gotten about $24,000 more.
North Florida Democratic Rep. Allen Boyd has taken in $35,000 from PACs, building on the $42,000 he got in the first six months of the 2008 cycle.
By far the most money has gone to Rep. Kendrick Meek of Miami, who is running for the U.S. Senate seat being vacated by Mel Martinez. This year, the Democrat has received $254,000 from health care interests. (A statewide campaign always draws more money.)
The Times' analysis looked at medical and drug trade groups as well as individual contributions from doctors, specialists and insurers. Life and auto insurance contributions were excluded.
Lawmakers strongly deny the donations from the health care industry have an outsized influence. "It has absolutely no bearing in how I vote," said Bilirakis, who opposes the public insurance option for fear it will hurt small businesses and cost taxpayers too much.
"Congresswoman Kosmas believes that the status quo is unsustainable as health care costs and insurance premiums are rising at a pace significantly higher than wages. She has met with constituents and stakeholders in the district and D.C. to hear all sides of the health insurance reform debate," said Leslie Pollner, Kosmas' chief of staff.
Meek can point to his July 17 vote on the House Ways and Means Committee in favor of a bill that includes a public health option. But critics say he and others have not insisted strongly enough that it be part of the final legislation.
"It's everyone's right to make campaign contributions. It's everyone's right to lobby," said Dave Levinthal with the nonpartisan Center for Responsive Politics. "At the same time, we want to make sure people who are sitting home in Orlando or Tallahassee or Tampa are very much aware of what industries are pressuring Congress."
Nationally, tens of millions of dollars have been poured into campaign accounts with an emphasis on those who control the outcome. Sen. Max Baucus, the Montana Democrat overseeing the Senate legislation, has received more industry money than nearly every other lawmaker in Washington.
And Boyd and other conservative "Blue Dog" Democrats in the House have taken in a record amount of money this cycle. Blue Dogs are almost single-handedly responsible for forcing their party to scale back the public option proposal in the House.
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Interest groups and lawmakers in both parties agree that health care reform is needed. But consensus quickly falls away on the best approach.
Drugmakers are sponsoring pro-reform ads and have run TV spots for Kosmas and Rep. Alan Grayson, the Orlando Democrat who like Kosmas faces a tough re-election campaign. But the companies are fighting proposals that would limit how much they can charge and how quickly generic drug versions can be introduced.
Likewise, insurers support a proposed mandate that all Americans carry insurance. But they do not think they should have to compete with the government.
"They want to turn the national desperation for affordable health care into a bill that really boosts their profits," said Jerry Flanagan, health care analyst with Consumer Watchdog, a California advocacy group. "They are getting Congress to do their dirty work."
Pfizer spokeswoman Sally Beatty said the company wants to push for innovation and reform while maintaining competitiveness. "We believe our bipartisan efforts have played a constructive role in the process, and we will continue to do so," she said.
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So what effect has all the lobbying and money had? That's difficult to answer as the debate has moved from Capitol Hill to forums across the country.
There is considerable support for a government-run plan, but also staunch opposition, which is evident amid the shouting at town hall meetings held during the August congressional recess.
The hard choices lawmakers face are symbolized by Kosmas, who has gotten about $53,000 in donations this year related to health care. All told she has raised $603,000 in part because she is a member of the House Financial Services Committee.
Democratic leaders, including Obama, have made a hard push for the government-run plan but support has steadily eroded due to the lack of a strong unified front. What may emerge is a provision for health insurance cooperatives.
Kosmas comes from a district that leans Republican, and the GOP is fighting to regain the seat in 2010. Supporting a government expansion during a time of bailouts and huge deficits could deal her a death blow.
Kosmas has avoided saying anything too specific. In a recent newspaper column she signaled skepticism of the government plan, which could cost $1 trillion or more over a decade.
"I always have been committed to fiscal responsibility, and I am concerned independent analysis shows that no bill before Congress does enough to lower costs over the long term while being deficit neutral," she wrote in Florida Today on Aug. 9.
That may be what Brown, the insurance broker who visited her in July, wants to hear. But he insists the financial support of Kosmas — the firm was a big contributor in 2008 — is based on their long friendship and a belief that as a Democrat, she is a good voice in Washington.
"We are involved in the political process," he said, "and the political process runs on green."
Alex Leary can be reached at firstname.lastname@example.org.