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Senate Finance and HELP: Two Very Different Animals

In the Senate, two committees have jurisdiction over health care reform, and both are preparing landmark bills. But from the K Street point of view, all panels are not created equal.

Industry lobbyists regard the Health, Education, Labor and Pensions Committee as the more liberal panel whose bill is largely a reflection of more left-leaning, less business-friendly priorities. It is the Finance Committee — where Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) have a good rapport — where lobbyists say they are turning to broker deals on some of the most complex and controversial aspects of reform.

And while they aren’t ignoring HELP, lobbyists expect Finance to hold the upper hand when, or if, the two bills should merge into one.

“Are people going to the Senate Finance Committee with potential compromises and solutions in the health care debate that they’re not taking to the HELP Committee? Definitely,— one health care lobbyist said. “There is no doubt that the dialogue between K Street and the Finance Committee is a very different one than at HELP.

“Lobbyists understand the difference between the two, and you definitely have a different approach,— added this lobbyist, who would speak only on background. “Finance is where most of the industry is going because it has lead jurisdiction on the most controversial items,— the lobbyist said, including insurance market and Medicare reforms, insurance and financing reforms, individual and employer mandates, and all the pay-fors.

HELP has opened its door to stakeholders of all stripes in a session of workhorse meetings, but the Finance Committee — which has issued orders to lobbyists to hold their fire to give time for a compromise to be reached — is getting the highest marks from industry groups.

Lobbyists from both sides of the aisle say that Finance has played its outreach to business groups masterfully.

“It’s about the best I’ve ever seen,— said one Democratic lobbyist who works on health care. “They have been incredibly savvy and fair.—

Another health care consultant said that “downtown has always taken the Finance Committee process far more seriously— and that has only become more so as the process unfolds.

“It’s been clear for some time now that the HELP Committee process was going to be a strictly partisan process,— this consultant said. “So for stakeholders, from the global standpoint, people aren’t paying as much attention to the HELP Committee because they’re not going to be receptive either to the minority party or to downtown.—

Julius Hobson, a senior policy adviser at Bryan Cave who was once an in-house lobbyist for the American Medical Association, said a group’s legislative priorities are the guide as to which committee is the right spot.

Hospitals and other groups concerned with Medicare and Medicaid funding hits naturally will be at Finance, while firms that are promoting wellness programs and preventive care will talk to HELP.

Groups lobbying for or against a public plan, he said, are lobbying both committees.

“It has to do with in what basket are most of your eggs,— Hobson said. “That’s where you’re going to spend most of your time.—

He added that lobbyists must keep in mind the endgame when, at least theoretically, the two bills would merge into one.

“What makes this so weird is you’ve got to look at the separation, but eventually you’ve got to look at the blend,— he said. “You want to make sure you come out OK in both bills, so hopefully when they blend them together you’re not negatively impacted.—

One lobbyist, speaking only on background, said the Finance version holds the most promise.

“When they merge those two bills, if they do pull off a bipartisan bill, Finance will have the upper hand because they will have maneuvered in a more sophisticated way, especially if they have some large providers and stakeholders complicit in the deal,— this lobbyist said.

Ron Pollack, executive director of the health-care-focused consumer group Families USA, said that perhaps because of the absence of HELP Chairman Edward Kennedy (D-Mass.) or because ranking member Mike Enzi (R-Wyo.) is also on the Finance panel, “the process of achieving bipartisanship has not occurred at the same pace— on HELP as on Finance.

“I think the Senate HELP Committee will probably have a more robust vision about the directions for health reform, and the Senate Finance will have more of a compromise approach that has significant input from potential supporters on the Republican side,— Pollack said. “Once the HELP Committee bill came out, I think some of those industry groups decided to put more attention into the Finance Committee. From their perspective, I think they felt they had a better chance of achieving satisfaction through a compromise bill rather than a bill that has a more robust vision.—

Pollack’s group is reaching out to both committees.

“The bottom line, from the perspective of those of us who care deeply about the overall package, we’re working closely with both committees,— he said.

And Robert Zirkelbach, spokesman for America’s Health Insurance Plans, said that his boss, Karen Ignagni, was among many who participated in the HELP workhorse sessions. He gave both committees high marks for embarking on an “open and inclusive— process.

HELP is also the panel of jurisdiction when it comes to lobbying over finding a pathway to generic or “follow-on— biologics. That issue pits biotech and name-brand pharmaceuticals against generics makers and coalitions that want fewer years of market exclusivity for new, brand-name biotech therapies. And HELP will also be tasked with wellness and prevention programs that many companies want to see included as part of overall reform.

“There’s a lot of support in the business community for them,— a health care industry lobbyist said.

Another health care industry lobbyist said he believes the HELP workhorse meetings were “a legitimate attempt by the staff to reach out and engage.—

But he said no one on K Street was expecting HELP to produce a product that the business community would cheer because of the panel’s liberal Democratic membership, including No. 2 Sen. Chris Dodd (Conn.) and Sens. Tom Harkin (Iowa), Barbara Mikulski (Md.) and Sherrod Brown (Ohio).

“These are extremely liberal Members,— this lobbyist said. “At the end of the day, no one downtown believed that those Members would compromise.—

By contrast, this lobbyist said, the meetings at the Finance Committee are “more engaging and substantive because you sensed that they were looking for a more centrist-bipartisan solution.—

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