From a mothers’ helper, a lesson in lobbying

Health care lobbyist Karen Fennell stands on Capitol Hill in Washington, Thursday, Sept. 24, 2009. (Evan Vucci/AP) Health care lobbyist Karen Fennell stands on Capitol Hill in Washington, Thursday, Sept. 24, 2009.
By Julie Hirschfeld Davis
Associated Press / September 29, 2009

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WASHINGTON - Karen Fennell is not your typical high-rolling lobbyist with a fat expense account and clients paying six-figure fees.

But this former nurse is doing something Gucci-clad lobbyists would envy: She has won her clients some coveted federal money in the battle over health care.

How she did it is a case study in how Washington’s influence game can work, even for those without bottomless checkbooks. She cultivated key allies in Congress, crafted an argument that aligns with the prevailing political winds, and represents a constituency no lawmaker could shun: mothers-to-be.

Fennell’s clients are birth centers around the country that mainly serve pregnant women who are too poor or too far away from a hospital to have any other option for prenatal care or delivering their babies. Fennell is happy to show lawmakers a letter signed by thousands of their female constituents pleading to keep birth centers open.

And while she lacks the money to make hefty campaign donations, she has another financial pitch: an official opinion from congressional budgeteers that says her proposal will actually save the government cash. That kind of blessing is increasingly valuable in a health care debate obsessed with cost savings and lowering the deficit.

Old-fashioned connections haven’t hurt either. Fennell, a seasoned community activist on women’s health issues, was friendly with the late wife of Steny Hoyer, a Maryland Democrat and the House majority leader, who happens to be her congressman. She used to represent the American College of Nurse-Midwives and has worked closely with lobbyists who are helping to shape the health overhaul.

She prowled the hallways of a House office building recently, checking in with supporters of her initiative to make sure they were still on board. And she had this to say about lawmakers who aren’t backing her: “I don’t have a hit list, because I know tomorrow, I’m going to need them for something else.’’

With her simple, low-budget tactics, Fennell is a rare exception in a health care debate awash in special-interest money and campaign contributions. She has pocketed less than $25,000 over the last two years lobbying for the birth centers - spare change in the context of the nearly $750 million that insurers, drug makers, and other medical interests have spent trying to get what they want out of the health care bill. Her only real opponent, the American College of Obstetricians and Gynecologists, has spent nearly $1.2 million lobbying during that time, including resisting reimbursement for birth centers without credentials and midwives trained to deliver outside of hospitals.

“To us, it’s a safety issue,’’ said Gerald F. Joseph, the obstetrician group’s president. “We just want birth centers and the providers in these birth centers to go through what we view as the proper credentialing.’’

Fennell, who’s lobbied on behalf of the American Association of Birth Centers to make sure that Medicaid pays them back, appears to be winning. Three House committees have approved measures that would allow the reimbursement, and a Senate measure by the Finance Committee chairman, Max Baucus, would require it.

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