U.S. District Judge Henry Hudson in Richmond, Virginia, said yesterday that the mandate on individuals in President Barack Obama’s health-care legislation goes beyond Congress’s powers to regulate interstate commerce. Hudson severed the issue of the mandate, which is set to become effective in 2014, and didn’t address other provisions such as expanding Medicaid.

“At its core, this dispute is not simply about regulating the business of insurance — or crafting a scheme of universal health insurance coverage — it’s about an individual’s right to choose to participate,” wrote Hudson, who was appointed by President George W. Bush in 2002.

The ruling is the government’s first loss in a series of challenges to the law mounted in federal courts in Virginia, Michigan and Florida, where 20 states have joined an effort to have the statute thrown out. Constitutional scholars said unless Congress changes the law, its fate on appeal will probably be determined by the U.S. Supreme Court.

Virginia Attorney General Ken Cuccinelli, who brought the suit, said his office has spoken with lawyers from the Justice Department about asking the U.S. Supreme Court to take the case without a review by the federal appeals court in Richmond. Tracy Schmaler, a Justice Department spokeswoman, said she had no comment on Cuccinelli’s statement.

Appeal Likely

A senior Obama administration official said that an appeal of Hudson’s ruling was likely and also expressed confidence that the legislation would be upheld.

“This is only round one,” Cuccinelli said, during a news conference at his office in Richmond. “This lawsuit is not about health-care, it’s about liberty.”

In his 42-page opinion, Hudson said the “unchecked expansion” of congressional power represented by the insurance requirement “would invite unbridled exercise of federal police powers.” No Supreme Court decision has authorized Congress to “compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market,” he wrote.

To overcome that conclusion, the Obama administration ultimately may have to persuade at least one of the five Republican-appointed justices on a Supreme Court that in recent years has limited Congress’s power to regulate interstate commerce.

Commerce Clause Cases

The court hasn’t directly considered a challenge to Congress’ power under the Constitution’s commerce clause since John Roberts became chief justice in 2005.

“There’s a lot of activity focused now on alternatives to the mandate,” said Dan Mendelson, chief executive officer of Avalere Health, a Washington-based consulting firm.

Hudson, who didn’t order the government to stop work on implementing the law during an appeal, limited his ruling to the mandatory insurance provision.

Peter Urbanowicz, a managing director at Alvarez & Marsal Healthcare Industry Group in Washington, said he read the decision to leave in place all of the law’s obligations on insurers for expanded coverage. If Hudson’s decision is upheld, insurance companies would be required to provide new benefits without expanding the pool of insureds, he said in an e-mail.

That would cause “skyrocketing costs” for insurers, said Robert Zirkelbach, a spokesman for the Washington lobby group, America’s Health Insurance Plans.

Health-Insurance Stocks

Health plans rose as much as 2.7 percent after the ruling was announced, and then fell back. The Standard & Poor’s Managed Health Index of six insurers climbed 0.3 percent in New York trading, led by a 1 percent increase for Aetna Inc. of Hartford, Connecticut. UnitedHealth Group Inc. of Minnetonka, Minnesota, the largest medical plan by sales, rose 0.6 percent.

White House spokesman Robert Gibbs said at a press briefing yesterday said that the administration still believes the legislation is constitutional.

“One hundred and fifteen miles away, a different judge in a different district rendered a different decision,” Gibbs said, referring to a Nov. 30 ruling by U.S. District Judge Norman Moon, in Lynchburg, Virginia, named by President Bill Clinton. That decision upheld the act in a lawsuit brought by the evangelical Liberty University and five individuals. U.S. District Judge George Caram Steeh in Michigan, another Clinton appointee, also sided with the government.

‘Will Be Upheld’

“Our belief is that when all the legal wrangling is done, this is something that will be upheld,” Gibbs said.

Justice Department lawyers in court papers called the mandatory insurance measure the cornerstone of the overhaul as it pushes younger and healthier people into the insurance pool. Through the individual mandate and expansions of Medicaid and employer-based coverage, the law is estimated to provide 32 million more people with coverage by 2019, according to the Congressional Budget Office.

The law bars insurers from denying coverage to people who are sick or imposing lifetime limits on costs. Without payments generated from the required policies, the health-insurance market would face extinction, the government argued. The mandate falls under Congress’s power to regulate interstate commerce as $43 billion in unpaid medical bills are absorbed by the market each year, U.S. lawyers said.

‘Simply Wait’

“If people aren’t compelled to buy insurance and the insurance carriers are compelled to offer it, then many will simply wait until they are sick,” said John Sullivan, an analyst at Leerink Swann & Co. in Boston. “You can’t just pull this part out of it.”

Virginia’s suit claimed Congress has only the power to tax, not to force participation in a market. Its case defended the Virginia Health Care Freedom Act, a state law barring compulsory purchase of health insurance by its citizens.

Florida, joined by 19 other states, filed a separate lawsuit challenging the law’s constitutionality and arguing it puts too big a burden on its budget by expanding state-run Medicaid programs. U.S. District Judge Roger Vinson in Pensacola, Florida, is slated to hear arguments Dec. 16 on motions by each side to decide the case in their favor.

In the Florida case, the states are backed by 63 members of the U.S. House of Representatives, mostly Republicans, in a court brief. Incoming House of Representatives Speaker John Boehner, an Ohio Republican, and 32 Republican U.S. senators separately submitted papers arguing the legislation represents an unconstitutional expansion of congressional legislative powers.

Expansion of Medicaid

Florida’s Attorney General Bill McCollum said he is hopeful Vinson will strike down the individual mandate and halt the expansion of Medicaid.

“The implementation of this law could add more than 1.9 million Floridians to the Medicaid program, a tremendous financial burden on our state at a time when our budget has no room for extra expenses,” he said in a statement.

A group of about 40 economics scholars, including Nobel laureates Eric Maskin, George Akerlof and Kenneth Arrow, filed their own brief, arguing in favor of the legislative package.

The Virginia and Florida cases are the most likely to reach the Supreme Court, according to health-care and constitutional lawyers.

www.bloomberg.com

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A study on diabetic patients by the University at Buffalo School of Pharmacy and Pharmaceutical Sciences identified cost savings with improvements in a key indicator of glucose control in diabetes patients, the hemoglobin A1C measurement. The A1C provides a three-month average of the amount of excess glucose in the blood. Higher A1Cs indicate that a patient is at higher risk for developing long-term complications associated with diabetes, such as kidney disease or vision problems.

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Published last spring in the Journal of the American Pharmacists Association, the UB study of 50 patients with Type 2 diabetes demonstrated that in just six months clinical pharmacists, in collaboration with primary care providers, were able to significantly reduce patients’ A1C levels.

In the UB study, patients’ A1C levels were reduced by an average of 1.1 percent, from an average of 8.5 percent to 7.4 percent, one year after being enrolled in the program, while also improving the overall metabolic profile.

“Our results show that enhancing the patient’s access to care through collaborative physician-pharmacist relationships can yield lower blood glucose levels, improve the overall metabolic profile and reduce costs to the payer,” says Erin Slazak, PharmD, UB clinical assistant professor of pharmacy practice and board certified pharmacotherapy specialist.

These clinical improvements occurred while monthly costs per patient went down by approximately $212, around $2,500 per year, even though there were nominal increases in the cost of medications prescribed.

The key to success?

“Patients had unlimited access to pharmacists throughout the year,” says Slazak.

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Patients referred to the UB program had been identified by their primary care providers as having difficulty controlling their blood sugar. Slazak notes that it was not uncommon to see patients with glucose levels as high as 400 mg/dl (normal levels are below 100 mg/dl).

The UB pharmacists spent an initial one-hour appointment with each patient, where they worked up detailed health records covering dietary information and all medications and disease conditions, and then reviewed them with each patient.

After that, patients could call or make appointments with pharmacists at will.

“We did extensive education with patients about how to manage their conditions,” says Slazak. “In many cases, we were instrumental in getting them to start insulin. There is a lot of resistance to that, and not just because it’s an injection.”

For patients in the initial stages of administering insulin, she says it was common to be contacted once every few days. The pharmacists then made suggestions to physicians about changes in medications, dosages or lifestyle that might be beneficial to their patients.

That kind of individualized attention is far from the norm for diabetic patients.

“Nationwide, the standard of care is that the primary care provider manages diabetes alone,” says Slazak. “Pharmacists typically do not have direct involvement.”

That is partly because some states, including New York, have not yet approved collaborative practice agreements between physicians and pharmacists. In the Buffalo study, for example, physicians were required to review pharmacists’ recommendations and approve all interventions first. Completion of the review process and approval occurred in only half of the cases, potentially limiting the overall benefit to the patient.

“We know there’s a long-term clinical and economic benefit to pharmacists working directly with patients and we think that can continue to grow,” says Scott V. Monte, PharmD, UB clinical assistant professor of pharmacy practice and director of Diabetes and Cardiovascular Research, CPL Associates, LLC, in Buffalo. “Pharmacists can help achieve better outcomes if given the chance.”

The study was conducted through MedSense™, part of the Pharmacotherapy Research Initiative, a collaborative effort between Lifetime Health Medical Group and UB, to study how pharmacists impact patient care. MedSense™ is one of many program sites that are part of the UB Pharmacotherapy Research Initiative in the School of Pharmacy and Pharmaceutical Sciences, which was established to study how pharmacy medication management can improve the health of patients while cutting costs through patient-centered pharmacotherapy.

In addition to Slazak and Monte, other co-authors on the paper include Nicole Paolini Albanese, PharmD, UB clinical assistant professor; Martin Adelman, PhD, chief information officer at CPL Associates, LLC; Gauri Rao, a student in the UB School of Pharmacy and Pharmaceutical Sciences, and Joseph A. Paladino, PharmD, UB professor of pharmacy and director of outcomes research at CPL Associates, LLC.

The program is jointly funded by Lifetime Health Medical Group and the UB School of Pharmacy and Pharmaceutical Sciences.

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The health-care industry added an additional 29,000 jobs in October, nearly the same amount it grew in September. In total, since the start of the recession, the industry has added 597,000 jobs, according to the BLS.

The biggest month-to-month jump came in the category of health care and social assistance, which added approximately 3,400 positions.

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And like in September, there was growth across all health-care sectors, including in hospitals, ambulatory-care settings and in doctors’ offices.

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THE ISSUE: How much do Americans who have employer-sponsored health insurance pay in premiums? What do their employers pay? Would that change if the system is overhauled?

THE POLITICS: Health care costs have been increasing. For Americans and the businesses that insure most of them, that translates into higher insurance premiums. The average premium cost for employer-provided insurance has doubled since 2000. These days, coverage for an individual with employer-provided insurance costs on average $4,824 a year, with the employee paying $779 of that amount, according to a 2009 survey by the Kaiser Family Foundation and Health Research and Educational Trust. For a family plan, the premium is $13,375 with the employee paying $3,515. Under current law, the Congressional Budget Office estimates that in 2016 average premiums for employer-based insurance will rise to about $7,500 for a single policy and about $19,000 for a family policy.

WHAT IT MEANS: Numerous factors will affect the cost of insurance under proposed health care bills, making their impact hard to predict. But President Barack Obama has vowed to lower the cost of health care. A recent study by America’s Health Insurance Plans said the most moderate of the Democrats’ health insurance plans would increase premiums. But the study only examined select aspects of the bill and ignored provisions aimed at making health care more affordable. The legislation would set up exchanges where companies would compete for customers. It also would provide subsidies for lower-income people.

_ Jim Kuhnhenn

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The town hall meetings, not unusual for the August Congressional recesses, according to FGCU public affairs professor Peter Bergerson, have been marked with near riotous conditions this year, all from health care foes. On Wednesday, Sen. Arlen Specter, D-Pa., was met with jeers and taunts in State College, Pa.

Many meetings have had so much disruption, discussion of the issues had to be suspended.

Someone painted a swastika on a sign outside the office of Democratic Rep. David Scott of Georgia.

Presidential spokesman Robert Gibbs called the spray painting “ridiculous,” saying it’s a sign the national debate over Obama’s health care plan has gotten “completely out of hand.”

No town hall meetings have been held in Lee County, although opponents and supporters of an overhaul have held rallies.

Obama came through the Portsmouth meeting unscathed Tuesday, facing a mostly friendly and, with Hershenson as an example, courteous crowd.

Hershenson’s courtesy and good humor make him no less critical of Obama’s health care plans. Nor is he any less critical of what he considers to be rampant spending of taxpayer money in Washington, D.C., the real cause, he believes, for the rowdy, anger-filled town meetings.

Hershenson, 69, who summers in Maine, was picked randomly by a White House staffer after applying online to attend the meeting and then, there, was selected again, perhaps not so randomly this time, by Obama to ask a question.

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But possible solutions have not evolved either, in part because new proposals seldom build on old ones. Obama’s broad, leave-the-details-to-Congress proposal has little in common with the 1,300-page measure President Bill Clinton couldn’t even get to a vote in a Democratic Senate in 1993.
The Obama strategy was designed to avoid mistakes Clinton made in confronting Congress with a massive bill written in the White House under the management of Hillary Rodham Clinton and essentially telling the House and Senate to take it or leave it. Clinton threatened to veto any bill that did not deliver universal health care. He got nothing to veto.
The Obama team missed part of the lesson when the president pressed for passage of House and Senate bills before Congress took its summer vacation so that they could negotiate a final version when they reconvene in September. What he got was narrow committee approval in the House, a preface to debate and action after Labor Day. In the Senate, the Finance Committee was trying to meet a Sept. 15 deadline to deliver its bill.
Obama’s push for action before the summer recess created a goal the Democrats couldn’t meet and a psychological setback he didn’t need to risk. He now says that it was no big deal and that what he wants is a reform law by the end of the year, to get all Americans insured and curb medical costs.
That is a big deal, underscored by his aggressive television and traveling campaign to try to build public support — and pressure in Congress — to enact health care overhaul this time.
“Now is the hard part — because the history is clear — every time we come close to passing health insurance reform, the special interests fight back with everything they’ve got,” Obama told a town hall in Portsmouth, N.H., on Tuesday. “They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do.”
Short of it, he and the Democrats could have a major political burden going into the 2010 congressional elections, just as Clinton did when Democrats lost the 1994 elections after his health care failure.
An issue that affects all Americans, their doctors, insurers and employers is bound to carry political risk.
Franklin D. Roosevelt wanted national health insurance but, even with his power in the New Deal Congress, he did not dare to tie it to Social Security in 1935 lest he lose the whole program. Harry S. Truman pushed it on a Congress that wouldn’t buy it.
While Dwight D. Eisenhower balked at national insurance, he tried to get Congress to support a reinsurance program to buttress private insurers and gain coverage for high-risk patients and the needy.
Congress said no, twice.
John F. Kennedy made health care a major issue in his 1960 campaign. He concentrated on what then was called medical care for the aged, a title that wouldn’t play well with the current Medicare set, people now described as senior citizens. He couldn’t get it through Congress.
Lyndon B. Johnson did, but even with his legendary legislative skills and the overwhelming Democratic majorities in Congress after the 1964 elections, it took more than a year of hard, sometimes arm-bending persuasion to get Medicare enacted. It was a hard sell with conservative Democrats, not unlike the problem Obama faces now.
That one major victory for government health insurance was an exception to the pattern of starting each attempt from scratch instead of evolving it from what had gone before. When Johnson signed the Medicare bill in 1965 and gave Truman card No. 1, he traveled to Independence, Mo., to share “this moment of triumph” with the president who had first proposed it 20 years before.
It provided government health insurance at age 65, tied to Social Security. Broader coverage, which FDR, Truman and Johnson all would have liked to gain, was beyond political reach.
Not only for LBJ, but also for Republican Richard M. Nixon, who proposed universal health insurance in 1974, seeking to use employer-based coverage along with federal subsidies so that all Americans would be insured. It was to be done by private insurers, not the government. There was bipartisan support until Watergate intervened.
The political perils of change were dramatized in 1988 after Congress enacted a Medicare overhaul that included prescription drug benefits financed with higher fees on upper-income recipients, who rebelled. They protested, demonstrated and even chased the sponsor, then-Rep. Dan Rostenkowski, D-Ill., to his car. Those changes were repealed the next year.
Prescription drug coverage was added to Medicare in 2003, pushed by President George W. Bush, who claimed it as one of his major achievements in winning re-election. It did not come easily. The administration understated cost estimates by half, and Republican leaders muscled it through the House by one vote. To hold down the cost, they wrote a gap into the coverage.
That may be changed in an Obama health plan. It points to a chronic challenge in health overhaul efforts: the price of change. Covering nearly 50 million uninsured Americans would cost an estimated $1 trillion-plus over the next decade. Obama promised to do it without adding to the deficit. Now he and Congress have to figure out how.

EDITOR’S NOTE _ Walter R. Mears reported on government and politics for The Associated Press for more than 45 years. He is retired and lives in Chapel Hill, N.C.

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“In the past, these certificate programs have been very successful, drawing community members from throughout Metro Detroit,” said Joan Stephens, director of Madonna’s Continuing Education program. “The majority of those enrolling are laid-off workers, stay-at-home mothers returning to the workforce, and people looking to switch careers.”

The fall schedule for Madonna University’s medical certificate programs is as follows:

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The National Federation of Independent Business (NFIB), National Rural Health Association (NRHA), American Association of Diabetes Educators (AADE), and the Diabetes Access to Care Coalition (DACC) have all sent letters to the Senate and House committees of jurisdiction supporting accreditation exemption bills.

Also, House Democratic leaders have included similar provisions in their healthcare reform bill H.R. 3200, America’s Affordable Health Care Choice of 2009. And key U.S. lawmakers have written to the Centers for Medicare and Medicaid Services (CMS) asking that pharmacies be exempted.

“The DME accreditation and surety bond requirement deadlines are fast approaching, and for patients who depend on supplies such as diabetes test strips, this is problematic,” said Bruce T. Roberts, RPh, NCPA executive vice president and CEO. “The reason is many community pharmacies might stop selling these supplies, which complement the medications patients get from their stores. In underserved communities the ensuing access problems could be even more acute.”

Other healthcare providers have already been exempted from these redundant, cost-prohibitive, and time-consuming regulations that are designed to prevent fraud by Medicare Part B suppliers. No evidence has been brought forward to suggest that pharmacists have engaged in any illegal behavior.

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In all, CDC’s Advisory Committee on Immunization Practices (ACIP) recommended five groups to receive the initial doses of vaccine. These groups are pregnant women, household contacts of children less than six months of age, health care workers and emergency medical services personnel, people age 6 months through 24 years, and adults age 25–64 years with chronic conditions that increase the risk of influenza-related complications.

“These are groups that had higher risk of disease or who had greater burden of complications” so far during the pandemic, said Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases, at a media briefing after the advisory meeting. In all, about 159 million people are included in the targeted groups.

Initial epidemiologic data suggested that obese people could be at increased risk for death after infection with the pandemic H1N1 2009 influenza virus. But newer data indicate that obesity is not an independent risk factor for death, Anthony Fiori of CDC’s influenza division told the committee members.

Notably absent from the priority list is the 65-and-older population, a group at high priority for vaccination against seasonal influenza viruses. The advisers agreed that epidemiologic data show that the H1N1 2009 influenza virus targets younger age groups.

“The H1N1 outbreak so far has, to a large extent, spared [the elderly] population,” Schuchat said.

The advisers recommended that once local public health officials believe the demand for vaccine has largely been met among the priority groups, efforts should be made to vaccinate adults 25&ndash64 years. Only after the demand for vaccine has been met among these adults should those age 65 or older be targeted for vaccination.

The overall consensus was to define the targeted groups for vaccination as broadly as possible, taking into account the estimated initial vaccine supply.

Several committee members expressed concern that many people who should be protected may not seek vaccination if the prioritization plan is too narrow or complex.

“Tight prioritization will result in vaccine being unused,” warned William Shaffner, president-elect of the National Foundation for Infectious Diseases. “When you have it, just give it.”

Federal officials are projecting that at least 120 million doses of monovalent, licensed H1N1 2009 influenza vaccine will be available in October, and about 80 million doses will become available each month thereafter through next spring.

But more than 300 million doses of vaccine will probably be required to fully protect the initially targeted population.

“The working assumption is that you need two doses for everyone,” Fiori said.

Fiori said that during a normal influenza season, “about 20–50%” of those who should get vaccinated actually do so. Federal planners said that they do not know what the demand for H1N1 2009 influenza vaccine will be, but they do not expect all those targeted to seek vaccination.

Because of uncertainties about vaccine supply and demand, the committee was asked to consider whether certain subgroups should be targeted if there is a serious vaccine shortfall.

In this case, the group decided, vaccine should be recommended for five subgroups: pregnant women, close contacts of children younger than 6 months of age, health care and emergency services personnel with direct patient contact, children 6 months through 4 years of age, and children age 5–18 years with chronic medical conditions.

Fiori said about 42 million Americans would be targeted for vaccination under this plan.

A final recommendation from the advisers was to keep vaccinating priority patients as they arrive and not hold vaccine in reserve for patients for their second dose.

“Don’t set aside in your mind or your refrigerator a second dose,” Fiori said.

The federal government is stockpiling adjuvants for emergency use if clinical data indicate that these pharmacologic agents are needed to boost immunity and, potentially, stretch the vaccine supply.

“The decision to use or not use adjuvants has not been made at this point, but we want to be prepared for the worst-case scenario,” Robin Robinson, director of the Biomedical Advanced Research and Development Authority, told the advisers.

But the committee members based their recommendations on the monovalent, unadjuvanted vaccines that FDA has indicated can be licensed as a strain change to currently approved influenza vaccines. Licensure as a strain change is the regulatory path used each year when manufacturers prepare updated versions of trivalent seasonal influenza vaccines.

Kathy Neuzil, chair of ACIP’s influenza working group emphasized that no one knows how the pandemic will continue to unfold. She said plans for administering vaccines “may need to be reconsidered as the pandemic progresses.”

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WASHINGTON — On June 19, Arkansas Rep. Mike Ross made clear that he and a group of other fiscally conservative Democrats known as the Blue Dogs were increasingly unhappy with the direction that health-care legislation was taking in the House.

“The committees’ draft falls short,” the former pharmacy owner said in a statement that day, citing, among other things, provisions that major insurance companies also strongly oppose.

Ross was the guest of honor five days later at a “health-care industry reception,” one of at least seven fundraisers for the Arkansas lawmaker held by health-care companies or their lobbyists this year, according to publicly available invitations.

The roiling debate about an overhaul of the nation’s health-care system has been a boon to the political fortunes of Ross and 51 other members of the Blue Dog Coalition, who have become key brokers in shaping House legislation. Objections from the group resulted in a compromise bill this week that includes higher payments for rural providers and softens a public insurance option that industry groups object to.

The deal also would allow states to set up nonprofit cooperatives to offer coverage, a Republican idea that insurers favor as an alternative to a public insurance option.

At the same time, the group has set a record pace for fundraising this year through its political-action committee, surpassing other congressional leadership PACs in collecting more than $1.1 million through June.

More than half the money came from the health-care, insurance and financial-services industries, marking a notable surge compared with earlier years, according to the Center for Public Integrity.

A look at career contribution patterns also shows that typical Blue Dogs receive significantly more money — about 25 percent — from the health-care and insurance sectors than other Democrats, putting them closer to Republicans in attracting industry support.

Most major corporations and trade groups in those sectors are regular contributors to the Blue Dog PAC. They include drugmakers such as Pfizer and Novartis; insurers such as WellPoint and Northwestern Mutual Life; and industry organizations such as America’s Health Insurance Plans.

The American Medical Association also has been a top contributor to individual Blue Dog members.

Many liberal Democrats and advocates of health-care reform were angry about the compromise bill and view the Blue Dogs as being too cozy with drugmakers, hospitals and insurers and argue that they should be more supportive of the agenda set by President Obama and Democratic leaders.

“The Blue Dogs are carrying water for the industry instead of their constituents,” said Richard Kirsch, national campaign manager for Health Care for America Now, a liberal group. “In effect, the Blue Dogs and the Republicans are taking positions that are closer all the time and further away from what most Americans want.”

Aides to Ross and several other key Blue Dogs did not respond to requests for comment about their campaign contributions. But the lawmakers have said they are striving to represent the moderate views of their constituents, and that leaving health-care legislation to more liberal lawmakers such as Rep. Henry Waxman, D-Calif., would imperil the Democratic Party’s future.

Most Blue Dogs are from rural Southern and Midwestern districts that overwhelmingly voted for Republican Sen. John McCain over Obama in the presidential election.

“I know there were some that thought we were trying to stop health-care reform,” Ross told The Washington Post this week. “Nothing could be further from the truth. We simply wanted to slow the process down and ensure that we were working toward the kind of health-care reform that the American people need and want.”

Ross has received nearly $1 million in contributions from the health-care sector and insurance industry during five terms in Congress, according to the Center for Responsive Politics (CRP), which tracks campaign contributions.

The lawmaker founded Ross Pharmacy of Prescott, Ark., which he and his wife sold in 2007. The couple received $100,000 to $1 million in dividends last year from the sale, according to House financial-disclosure forms.

Records of political fundraisers since 2008 compiled by the Sunlight Foundation, a Washington, D.C.-based watchdog group, show a steady schedule of events for Ross sponsored by the health industry or lobbying firms that represent health-care companies.

Overall, the typical Blue Dog has received $63,000 more in campaign contributions from the health-care sector than other House Democrats over the past two decades, according to CRP. The top three recipients were North Dakota Rep. Earl Pomeroy, with $1.5 million, and Tennessee Reps. Bart Gordon and John Tanner, each of whom collected more than $1.2 million, according to the data.

David Donnelly, national campaigns director for the Public Campaign Action Fund, which favors public financing of political races, said the contributions cast doubt on the Blue Dogs’ motives.

“The public believes that campaign contributions shape or stop public policy,” Donnelly said. “When we see significant fundraising to one segment of Congress, it raises serious questions about the campaign-finance system and whether it works to the benefit of all Americans.”

But Charles Stenholm, a former Texas congressman who was part of the original Blue Dog group in the mid-1990s, disagrees. “The idea behind giving to a group like the Blue Dogs is that you believe that they will agree with your positions most of the time,” said Stenholm, who now lobbies for agricultural companies and some health-care firms. “The same is true for liberals or anyone else. It’s normal in politics.”

Washington Post reporter Lois Romano contributed to this report.

Copyright © 2009 The Seattle Times Company

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