The White House and Democratic lawmakers are signaling they are approaching the homestretch in the race to pass an overhaul of the health care system -- and interest groups are expected to flood the finish line with a torrent of modern and old-fashioned lobbying tactics.
The tactics include spending sky-high amounts on TV ads to staging rallies in the capital, and perhaps outside insurance company offices.
The AARP, the lobby for older Americans that has generally supported the health overhaul drive, is launching a massive, 8 million-piece direct mail campaign. The U.S. Chamber of Commerce will send lawmakers a letter next week signed by 2,800 companies and business groups opposing the effort, and is working with local chambers of commerce to bring business people to Washington to lobby legislators later this month.
The nation's TV stations, which last month hosted more than $28 million in ads on the health overhaul, may see even heavier spending in September, according to Evan Tracey, president of the Campaign Media Analysis Group in Arlington, Va. Should the health battle spill into December, this year's total might hit $200 million -- roughly the same as was spent in multiyear fights over tobacco regulation and the Medicare prescription drug program, said Tracey, whose company tracks political advertising.
"It's not just a couple of big players, this is coming from all corners, large and small," said Tracey, who said over 60 groups have advertised on the issue so far, more than he's seen on past issues. "This has only one way to go, and that's up."
The high-intensity lobbying underscores the pivotal moment that business, consumer, political and ideological groups believe is arriving in the health care fight.
President Obama and Democrats driving the effort lost ground during an August recess that saw noisy protests at some lawmakers' town hall meetings and dimming support for the president in polls. With Obama planning to address Congress on the issue Wednesday, interest groups want to help shape opinions as Obama and members of Congress decide what August meant and what the legislation should look like.
"The next few weeks are critical," said David Certner, legislative policy director for AARP.
His organization is running a national, multimillion-dollar TV ad campaign through mid-September that features an ambulance swerving from cars trying to block it as an announcer says, "Special interest groups are trying to block progress on health care reform, derailing the debate with myths and scare tactics."
Even so, some groups say they will restrain their spending for the next couple of weeks while assessing what Congress might do. Their decisions, in part, will be based on actions by leaders of the Senate Finance Committee, who by Sept. 15 are trying to craft a compromise seen by many as Congress' best chance at bipartisan legislation.
"We'll gauge where members of Congress are going as they come back, and then determine where we go from here," said Karen Ignagni, president of America's Health Insurance Plans, the insurance industry trade group.
The insurers, whom the White House and Democrats have painted as a villain in the health battle, have spent millions on ads supporting the general concept of overhauling the health system. But they strongly oppose Obama's proposal to create optional government-run coverage to help push down costs, which the White House has signaled it might abandon.
The Pharmaceutical Research and Manufacturers of America, poised to be the campaign's biggest spender with plans to spend up to $150 million in ads generally backing a revamping, will also hold back in early September while awaiting the Finance Committee's work, said Ken Johnson, a senior vice president.
Pressuring Obama from the left, the liberal MoveOn.org is emailing a petition to its members urging the president to retain a government-run insurance option in his plan. The American Federation of State, County and Municipal Employees has beefed up its door-to-door canvassing in 14 states, asking voters to tell undecided lawmakers that they should back a public insurance plan.
Health Care for America Now, an amalgam of more than 1,000 liberal and labor groups, is asking supporters to call lawmakers Wednesday and Thursday in support of an overhaul. It is also planning to have members hold demonstrations outside insurance company offices around the country later in September.
The National Physicians Alliance, a progressive doctors' organization, is considering banding with other medical groups to bring doctors to Washington for a rally in early October. The Tea Party Patriots, a national grass-roots conservative group fighting Obama's plan, is planning a demonstration in Washington on Sept. 12.
Conservatives for Patients' Rights, long one of the biggest advertisers opposed to Obama's plan, launches a $600,000 ad campaign Tuesday, the day Congress returns from its recess, saying Obama's plan could lead to government-run health care. Organizing for America, the Obama campaign apparatus now part of the national Democratic Party, is planning house parties across the country during the president's speech, at which supporters will be asked to contact their members of Congress to voice their support.
The Associated Press contributed to this report.