Health Care and Insurance Industries Mobilize to Kill ‘Medicare for All’

The mission of the industry partnership includes advocacy, advertising, lobbying and public education, but it has not registered under federal lobbying laws. Forbes Tate, a public affairs company that lobbies for many health care and drug companies, coordinates the work of the partnership, but is not registered to lobby on its behalf.

“There are no direct lobbyists for the partnership,” Ms. Shaver said. “We work through all of our different groups. They have their own lobbyists who do obviously lobby on Medicare for all. But there are no registered lobbyists for the partnership because we are not doing that directly at this time.”

The coalition, like President Trump, attacks any proposals that smack of socialized medicine. But it also has a positive agenda. It wants to expand Medicaid under the Affordable Care Act in Texas, Florida and other states that have yet to do so. It wants to expand federal subsidies under the health law so insurance will be affordable to more people. And it wants to stabilize premiums by persuading states to set up reinsurance programs, using a combination of federal and state funds to help pay the largest claims.

Beyond their desire to preserve the status quo, coalition members have done well by the Affordable Care Act. Many participants, such as the American Medical Association, the pharmaceuticals lobby and the hospital association, backed the A.C.A. from the start, banking that more insured Americans would mean more customers. The hospitals saw the health law’s Medicaid expansion as a lifeline as they struggled with the uninsured working poor.

Others, like the National Retail Federation, opposed the A.C.A. but have tried to make it work.

The need to bolster the Affordable Care Act will become even more urgent, the coalition says, if Texas and other states succeed in their lawsuit to invalidate the entire law.

Even without legislation to expand Medicare, the program is sure to grow because of the aging of the baby boom generation. The number of Medicare beneficiaries, 60 million today, is expected to top 75 million within a decade. The Congressional Budget Office estimates that Medicare spending will grow under current law to $1.5 trillion in 2029, double the total projected for this year.

E. Neil Trautwein, the vice president for health care policy at the retail federation, which represents companies like Walmart, McDonald’s and Amazon, said his top priority was to protect the stability of the coverage that employers provide to employees.