American Hospital Association
About 5,000 hospitals and health care networks are members of the AHA, including a large majority of the 5,708 registered hospitals in the U.S.
What They Want
The AHA promotes a five-pronged approach to health care reform: coverage, prevention, quality, cost control and information.

"We'd like to see health reform be comprehensive, not just focus on a couple of small dimensions," said Robert Umbdenstock, president and CEO. "We don't think any one of them will solve the problem."
Because hospital emergency rooms are legally obligated to provide health service for everyone, whether or not they're insured or can pay out of pocket, hospitals have an interest in universal coverage. The AHA has taken to promoting "coverage for all, paid for by all," saying all stakeholders -- individuals, businesses, insurers and the government -- must help with the inevitable costs of expanding coverage.
To do its part, the AHA, along with two other hospital associations, announced in July an agreement to take $155 billion in cuts in Medicare reimbursements and other payments over the next 10 years. The relinquished funds will instead be used for the health care overhaul.
To control overall health costs, the AHA proposes a focus on preventive measures, a reduction in administrative costs and improvement in chronic disease management; to improve quality of care, the group wants to see payment incentives and care coordination.
Finally, the AHA is calling for greater access to information, both on the provider side and on the patient side.
"We do want to see greater movement and sharing of information across the health system," Umbdenstock said, citing health information technology and "informed decision-making by patients and providing them with alternatives."
Deal Breakers
The AHA does not want to see hospitals take a significant financial hit as a result of the way health care reform is structured.
"Our ongoing concern, of course, as a major player, would be simple raw cuts in payments to hospitals," Umbdenstock said.
Specifically, the AHA is concerned about cuts to the Medicare and Medicaid Disproportionate Share Hospital programs, which provide federal funding to help hospitals treat low-income patients.
The AHA is also skeptical of a public insurance option because of the possibility of the option becoming "another form of government underpayment," though the group is not ruling out support of a public plan that would be available only to a restricted population, Umbdenstock said.
"Until we know how narrowly or how broadly constructed it is, it's not a yes or no question," he said.
How Much They've Spent
The AHA has spent about $7.1 million on lobbying activities in the first half of 2009, compared with about $7.9 million in the first half of 2008.
Individuals associated with the group and the group's PAC have contributed a total $463,035 to candidates and committees in the 2010 election cycle, and they contributed a total $2.1 million in the 2008 election cycle. The majority of that has gone to Democrats: 76 percent so far in the 2010 cycle and 63 percent in the 2008 cycle, according to the Center for Responsive Politics.
The AHA is a part of Divided We Fail, a coalition that has run television ads promoting health care reform. The association's total reported revenue in 2007 was $109.6 million.
Key Players
Umbdenstock, the hospital association's president and CEO, joined the organization in 2006. He was previously the executive vice president of Providence Health and Services, a Seattle-based integrated health care system. He has also worked as a consultant for voluntary hospital governing boards.
Umbdenstock visited the White House nine times in the first six months of the Obama administration, more than any other health care leader, the Washington Post reported. He announced his organization's $155 billion deal in July with Vice President Joe Biden at the White House. He has also testified before the Senate Finance Committee on health care reform.
Health care reform "is part of our ongoing set of priorities and activities," Umbdenstock said. "We've been in dialogues with health leaders on Capitol Hill. Since the beginning of this administration, we've been very much in dialogue with the Obama administration."
The AHA also partook in discussions through the Health Reform Dialogue, a coalition of groups representing a variety of health care stakeholders. The coalition submitted recommendations for reform to Congress in March.
Umbdenstock was a registered lobbyist his first two years with AHA, but not since 2007. Tom Nickels, the AHA's senior vice president of federal relations, heads a team of 28 lobbyists.
Links
AHA Health Care Reform Advocacy Page
"Hospital Lobbyists Try to Minimize Damage," Washington Post, July 25
Health Reform Dialogue Recommendations


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