bluecrossblueshield.jpgAs the health reform debate reaches its climax, insurance companies have worked hard to cultivate an image of being reasonable, practical players -- willing to work with the administration and Congress to craft a policy that works.Behind the scenes, however, the insurance lobby is much more aggressive about opposing reform, funneling hundreds of millions of dollars into lobbying, research, media and advocacy to defeat measures that might cut into industry profits.

Think Progress points to one interesting example: The support of Blue Cross Blue Shield Association -- a lobbying group representing the 39 independent BCBS plans -- for an effort to have key aspects of health reform rendered unconstitutional at the state level.

The Association publicly states that it supports health reform. But Joan Gardner, who is executive director of state services in the BCBS Association's Office of Policy and Representation, is part of a three-person task force that has written model legislation for states that would invalidate federal health care regulations, including the public option and individual mandates.

The task force pushing the measure was put together by the conservative American Legislative Exchange Council (ALEC). ALEC reports that 24 states have introduced, or plan to introduce, bills based on the proposal developed by Gardner and her associates.

The state bills are "tenther" amendments, based on the states' rights provisions of the 10th amendment to the U.S. Constitution.

But Think Progress also notes that it's an example of insurance companies like BCBS trying to have it both ways:
Part of the reason the BCBS Association has claimed that it opposes the reform bill in its current form is because of what it perceives as a weak individual mandate. However, the BCBS Association-supported ALEC campaign depicts the very notion of an individual mandate as "anti-freedom." So either way the Senate acts, BCBS will be able to trash the bill and try to kill reform.

According to ALEC, constitutional amendments have been filed or pre-filed in Arizona, Florida, Indiana, Michigan, Minnesota, New Mexico, North Dakota, Ohio, Pennsylvania, South Carolina, West Virginia, and Wyoming. Legislation is being discussed in 12 other states: Alabama, Alaska, Georgia, Kansas, Louisiana, Missouri, Mississippi, New Hampshire, Oklahoma, Montana, Tennessee, and Utah.

A bill passed the Arizona legislature in June, and will go to a public referendum in 2010.