Health insurance groups merging to gain lobbying clout.

Seeing little difference in their lobbying objectives, two health insurance associations might merge this fall to form what would be among time biggest health lobbies on Capitol Hill as healthcare issues such as Medicare reform have center stage.

Time boards of the American Association of Health Plans and the Health Insurance Association of America have agreed to merge, and members were expected to vote in late October.

When it comes to lobbying, "a message conveyed with one voice is more convincing and less confusing than when conveyed by two," said Susan Pisano, an AAHP spokeswoman.

Any historical differences in terms of products that health insurers offer, or policy positions or missions, have largely disappeared, said Pisano. "Wherever their roots are, companies have been diversifying and there's really been a great convergence in what kinds of products they offer. To the extent that this was the case three years ago, it's more the case today," Pisano said.

At one time, HIAA's members were mostly individual, small-group insurers, whereas AAHP members were the large managed-care companies, said Rob Guilbert, chairman of HIAA's public relations committee. Over time the two organizations have found more similarities than differences.

Part of the due-diligence process that went into examining merger possibilities included gathering all the policy positions for big and small health insurers, he said. The organizations found they were in sync and compatible. "There was not a dichotomy," said Guilbert, who is also a vice president with Fortis Health.

Each had subtle differences in their priorities, and those nuances might have shown up in their lobbying, but both acknowledge the financing of, and the accessibility, to, health care is the No. 1 domestic issue, Guilbert said.

Other major lobbying issues of importance to both organizations are the uninsured, rising health care cost, and Medicare, Pisano said. "On all those issues, we believe we can be more convincing and can contribute more to the national effort to address the nation's health care as one organization rather than two," she said.

Combined, the two organizations would represent about 1,400 member organizations--with about 1,000 coming from AAHP--that insure 200 million to 225 million people.

"I believe we'll be the biggest" health insurance lobbying group, said Pisano.

The Blue Cross and Blue Shield Association has worked with both AAHP and HIAA, said John Parker, a BCBSA spokesman. Though BCBSA has some of the same lobbying objectives and goals, "They have their issues, and we have ours. There are issues we may be more aggressive on than they are. But we will continue to work with them."

BCBSA represents 42 Blues plans across the country that cover nearly 89 million people, Parker said, noting that AAHP and HIAA have a broader constituency and thus would have more issues to address than BCBSA.

At a Glance: HIAA and AAHP

                   HIAA                    AAHP

Full Name:         Health Insurance        American Association
                   Association of America  of Health Plans

No. of Members:    About 300 health        About 1,000
                   insurance companies     health plans

Date Established:  1956                    1995, by the merger of the
                                           Group Health Association of
                                           America and the American
                                           Managed Care and Review
                                           Association

After merger

Will represent about 1,400 member organizations who provide coverage
for more than 200 million Americans

* Temporary Name: AAHP/HIAA
* President of Merged Group: Karen M. Ignagni
* Headquarters: Washington, D.C.