Blue Cross and Blue Shield Association
Blue Cross and Blue Shield Association (BCBSA) is the lobbying group for Blue Cross Blue Shield (BCBS), one of the largest providers of health insurance plans in the U.S. BCBS has about 40 chapters that provide health insurance to over 90 million people in the U.S. The chapters have health plans such as HMOs (Health Maintenance Organizations), PPOs (preferred provider organizations), POS (point-of-service), and fee-for-service plans. The chapters also administer Medicare plans for the federal government.
Support for the American Legislative Exchange Council
BCBS was a member of ALEC's Health and Human Services Task Force and BCBSA was a "Director" level sponsor of ALEC's 2011 Annual Conference, which in 2010 equated to $10,000. According to an August 2013 ALEC board document obtained by The Guardian, BCBS terminated its ALEC membership on April 4, 2013 "after losing on exchanges workshop."
ALEC is a corporate bill mill. It is not just a lobby or a front group; it is much more powerful than that. Through ALEC, corporations hand state legislators their wishlists to benefit their bottom line. Corporations fund almost all of ALEC's operations. They pay for a seat on ALEC task forces where corporate lobbyists and special interest reps vote with elected officials to approve “model” bills. Learn more at the Center for Media and Democracy's ALECexposed.org, and check out breaking news on our PRWatch.org site.
The state chapters or subsidiaries have separate PACs, for example Blue Cross/Blue Shield of Arizona gave $4,250 in 2006 - 35% to Democrats and 65% to Republicans. 
Opposing Health Care Reform
In December, 2009, Raw Story and ThinkProgress.org reported that BCBSA had been quietly working with the American Legislative Exchange Council (ALEC) to draft a resolution that would use the issue of state's rights to make health care reform (and regulation of the insurance industry) unconstitutional. ALEC drafted and distributed model legislation in the form of a resolution, that would effectively make both a federally-created health insurance exchange and a public health insurance option illegal under the 10th Amendment to the Constitution, which guarantees certain non-specific rights to the states. Joan Gardner, a senior executive at BCBSA, admitted playing a key role in crafting the resolution. Christie Herrera, who directs a health task force at ALEC, reports that insurance industry lobbyists have been working with ALEC to promote it to legislators. The resolution, and amendments closely related to it, have already been introduced in at least half a dozen states. ALEC has been working behind the scenes for months to advance the idea that proposals put forth by President Obama and the Democrats to regulate the insurance industry and enact a public option, violate states' rights.
By August, 2009, BCBSA and ALEC's "Tenth Amendment/health care resolution" had been introduced by Republican legislators in Indiana, New Mexico, North Dakota, Minnesota, Wyoming, West Virginia, and Florida, and Arizona's legislature voted to put it on the ballot in 2010, according to ALEC Health and Human Services Director Christie Herrerra.
BCBS spent $9,199,063 for lobbying in 2006. This total includes the parent BCBSA and the state subsidiaries such as Blue Cross/Blue Shield of Florida, Blue Cross/Blue Shield of South Carolina, etc. 
BCBS launched Get Health Reform Right. The site is billed as a grassroots campaign to "build on healthcare that works for so many to help cover the more than 45 million who still need coverage," but it is funded and directed by BCBS.
Institute for Clinical and Economic Review (ICER)
BCBS and its foundations and state entitites are significant funding sources  for the Institute for Clinical and Economic Review (ICER)[] a non-profit which has been criticized for providing insurers public support in their decisions to exclude prescription drugs from coverage. Steve Pearson, ICER's president and founder, was previously an AHIP senior fellow.
Key people: 
- Scott P. Serota, Chief Executive Officer
- Kathryn M. Sullivan, Chief Financial Officer
- Robert D. Rosecrans, Chief Information Officer
225 North Michigan Avenue
Chicago, IL 60601
- Blue Cross and Blue Shield Association Profile, Hoovers, accessed September 2007.
- Julian Pecquet, Blue Cross Blue Shield quits conservative legislative organization ALEC, The Hill, April 17, 2012
- American Legislative Exchange Council, ALEC 40th Anniversary Annual Meeting Board Meeting packet, organizational documents, August 6, 2013, released by The Guardian December 3, 2013.
- American Legislative Exchange Council, 2011 Conference Sponsors, conference brochure on file with CMD, August 11, 2011.
- Blue Cross and Blue Shield Association 2006 PAC, Open Secrets, accessed September 2007.
- Blue Cross/Blue Shield of Arizona 2006 PAC, Open Secrets, accessed September 2007.
- Sahil Kapur Blue Cross pushing plan to declare health reform unconstitutional, Raw Story, December 7, 2009
- Lee Fang Blue Cross Blue Shield Lobbyists Quietly Helping Extreme Effort To Declare Health Reform Unconstitutional, ThinkProgress.org, December 5, 2009
- Chris Good Republicans Going States' Rights On Health Care The Atlantic, Politics, August 14, 2009
- Blue Cross/Blue Shield lobbying expenses, Open Secrets.
- Blue Cross Key People, Hoovers, accessed September 2007.