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1	UNDERSTANDING THE POWER OF THE HEALTH INSURANCE INDUSTRY Jon Gabel Vice President, Health Research and Educational Trust
2	The Accidental System Born out of WWII wage-price controls. Altered by ERISA in 1974 Recent legislative acts HIPAA (1996) Mental Health Parity Act (1996) MMA (2003)
3	Evidence of the Power of the Health Insurance Industry Harry and Louise Medicare Prescription Drug, Improvement and Modernization Act $14 billion for Medicare Advantage Health Savings Accounts
4	Where Does the Health Insurance Industry Acquire Its Political Power? Low esteem by the public In Washington, closely aligned with the Republican leadership. In the states, brokers are a source of political power. More insurance agents in state legislative bodies than lawyers. Unique relationship with insurance commissioners. Much more effective when working with the business community
5	Industry Contributions for Congressional Campaigns, 1990-2002 (in millions of dollars)
6	Percentage of Industry Contributions for Congress Given to Republicans, 1990-2002
7	Top Ten Industries Contributing to State Party Committees, 2002 (in millions of dollars) Lawyers/Lobbyists Real Estate Public Sector Unions General Trade Unions Securities/Investment Insurance General Contractors Health Professionals Retail Sales $27.9 $17.7 $14.1 $11.7 $9.1 $7.1 $6.5 $4.9 $4.4 $3.9
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10	Conclusion Insurance industry political power is both member and money-based. Unique relationship with state commissioners At national level, industry is gambling on Republican dominance. Like other special interests, insurance industry will lose political power with reform of congressional elections.