In June 2018, a coalition of healthcare industry organizations formed in Washington, D.C. under the name the Partnership for America’s Health Care Future. Its website describes its mission as working “to improve what’s working in health care and fix what’s not.” Its stated goals include lowering costs, protecting patient choice, expanding access, improving quality, and fostering innovation.
These are goals that most Americans across the political spectrum would endorse without hesitation.
The organization’s documented purpose, as established through its own disclosures, its lobbying filings, its internal planning documents, and congressional testimony, is narrower than its name suggests. The Partnership for America’s Health Care Future was formed specifically to defeat Medicare for All, any form of single-payer healthcare legislation, the public option, and Medicare expansion before any of those proposals could gain sufficient public support to reach a floor vote in either chamber of Congress.
This article documents what the organization is, who its members are, what it has done, and where things stand.
Formation and Founding Members
The Partnership for America’s Health Care Future was founded in June 2018 by three organizations:
America’s Health Insurance Plans (AHIP) — the primary trade association representing the private health insurance industry in the United States. AHIP’s member companies collectively cover more than 200 million Americans through employer-sponsored plans, individual market plans, Medicare Advantage, and Medicaid managed care.
PhRMA — the Pharmaceutical Research and Manufacturers of America, the primary lobbying organization for the branded pharmaceutical industry. PhRMA members include most of the largest pharmaceutical manufacturers operating in the United States.
The Federation of American Hospitals — the trade association representing investor-owned, for-profit hospital systems and health systems. Its members operate hospitals across all fifty states.
After formation, the coalition expanded to include the American Hospital Association — the broader trade association representing nonprofit, for-profit, and government hospitals — and the Blue Cross Blue Shield Association, the national federation of thirty-six independent Blue Cross Blue Shield companies.
The coalition’s broader membership includes more than one hundred organizations in total — hospital associations, physician groups, insurance trade organizations, and related healthcare industry entities. The major founding and anchor members listed above are the ones whose organizational disclosures are most fully documented in public filings.
The AMA: A Member That Left
The American Medical Association was an early and prominent member of the Partnership for America’s Health Care Future. Its membership was cited in coverage of the coalition’s formation and activities through 2019 and into 2020.
In August 2020, the AMA left the coalition. The departure was reported by Politico and confirmed through the AMA’s own statements. The AMA did not publicly attribute its departure to a single stated reason. The context, documented in coverage at the time, included growing tension between the AMA’s leadership positions and the views of its physician membership.
Physician surveys throughout the period showed significant support for Medicare for All and single-payer options among practicing doctors — support that was inconsistent with the AMA’s membership in a coalition whose documented purpose was to prevent those options from advancing. The American College of Physicians, one of the largest physician specialty organizations in the country, had endorsed single-payer as a viable path to universal coverage. The internal tension between organized medicine’s institutional positions and its membership’s expressed preferences was a documented feature of the healthcare reform debate during this period.
The AMA’s departure from PAHCF does not mean the AMA endorsed Medicare for All. The AMA has maintained its own positions on healthcare reform independent of PAHCF membership. The departure is documented here because the coalition’s current membership is accurately described without the AMA, and because the circumstances of the departure reflect a broader dynamic in the healthcare reform debate — the gap between what industry organizations say on behalf of their sectors and what the individual practitioners in those sectors express when surveyed directly.
The Name
The Partnership for America’s Health Care Future registered as a 501(c)(6) business league and a related 501(c)(4) advocacy organization. Its public-facing website is americashealthcarefuture.org. Its communications consistently emphasize the language of improvement, innovation, and building on what works.
The gap between the organization’s name and its documented purpose was noted in coverage at the time of its formation and in subsequent reporting. An organization called “the Partnership for America’s Health Care Future” that exists to prevent specific healthcare reforms from advancing occupies unusual rhetorical territory — the name implies forward-looking improvement while the documented operational purpose is to block a specific category of legislative change.
This observation is not unique to one publication or one ideological perspective. The New York Times, The Intercept, Politico, and OpenSecrets all covered the coalition’s formation and activities. The characterization of PAHCF as a coalition organized around opposition to single-payer and Medicare expansion — rather than around the positive goals its name suggests — is consistent across that coverage and is supported by the organization’s own lobbying disclosures.
The Leaked Planning Documents
In November 2018, five months after the coalition’s formation, internal PAHCF planning documents were obtained and published by The Intercept. The documents provided direct evidence of the coalition’s strategic approach.
The leaked materials described a campaign explicitly designed to prevent Medicare for All from building sufficient public momentum to reach a floor vote. The strategy, as documented in the planning materials, included:
- Opposition research and message development targeting Medicare for All, the public option, and Medicare buy-in proposals
- Advertising campaigns designed to raise public concerns about cost and disruption
- Coordination with member organizations on messaging across media channels
- Lobbying activities directed at members of Congress from both parties
The documents were significant because they provided an unfiltered view of the coalition’s operational approach — distinct from the public-facing language on the organization’s website and in its press releases. The gap between the internal strategic documents and the public mission statement was a central element of the reporting.
PAHCF did not dispute the authenticity of the documents at the time of publication.
Activities and Scale
The Partnership for America’s Health Care Future has operated across several channels since its formation in 2018.
Advertising. PAHCF funded advertising campaigns in states with competitive Senate races and in national media during the period when Medicare for All was receiving significant congressional attention — 2018 through 2020, and again as healthcare reform re-emerged in the 2022 and 2024 legislative cycles. Healthcare advertising spending across the industry, including PAHCF-associated activity, exceeded $65 million in 2019 alone, according to tracking cited by Common Dreams. The specific portion attributable to PAHCF activities in any given year is not fully disclosed under current reporting requirements for 501(c)(4) organizations, which are not required to disclose their donors.
Lobbying. PAHCF and its affiliated action organization maintain registered lobbying operations in Washington, D.C. Lobbying disclosure filings through LegiStorm document activity through at least January 2026, confirming the organization’s continued operational status. The broader healthcare sector lobbying context established in Part 8 of this series — $439 million in annual healthcare lobbying in 2025 — represents the environment in which PAHCF operates as one of multiple coordinated industry efforts.
Research and messaging. PAHCF has funded and distributed research reports, polling, and policy analyses designed to raise questions about the cost and feasibility of single-payer proposals. The organization’s executive director, Lauren Crawford Shaver, has been the public spokesperson for coalition positions in media coverage and policy forums. PAHCF commissioned polling under the Voter Vitals name, releasing data intended to demonstrate public concern about government-run healthcare.
Media outreach. PAHCF has maintained an active communications operation, issuing press releases, op-eds under member organization bylines, and responses to legislative developments. The American Prospect documented that several prominent Democratic political consultants worked for PAHCF during the period of heaviest Medicare for All activity — a detail that illustrated the coalition’s bipartisan reach in its operational approach.
The Financial Stakes
Understanding the scale of what the member organizations have at stake in the current system provides context for the coalition’s activities.
Private health insurance is a multi-hundred-billion-dollar industry. The four largest health insurers — UnitedHealth Group, CVS Health/Aetna, Centene, and Elevance Health — posted combined revenues exceeding $1.2 trillion in 2025. AHIP’s member companies, taken together, represent the entirety of the private health insurance market.
Under Medicare for All as proposed in the Sanders bill, private health insurance for covered services would be prohibited. The private health insurance industry, as it currently exists for basic coverage, would cease to operate in that market. The financial interest in preventing that outcome is direct and quantifiable.
For pharmaceutical manufacturers, Medicare for All would establish the federal government as the sole negotiating counterparty for drug prices across the entire US market — the monopsony purchasing power that every other wealthy country uses to pay substantially lower prices than the US currently pays. RAND Corporation research documents that US drug prices average 2.78 times the OECD comparable-country average. The price differential represents the ongoing financial value of the current prohibition on direct government negotiation.
For for-profit hospital systems, single-payer would replace the negotiated commercial reimbursement rates — which are substantially higher than Medicare rates for many services — with government-set rates. The margin between commercial and Medicare rates represents a significant component of for-profit hospital revenue.
These financial stakes are not hidden or inferred. They are the documented revenue structures of the industries whose trade associations formed and fund PAHCF.
What PAHCF Has and Has Not Achieved
What it has achieved: Medicare for All has not received a floor vote in either chamber of Congress. The public option, despite majority public support and periods of Democratic legislative majorities, has not been enacted at the federal level. Medicare expansion proposals have advanced incrementally — the Inflation Reduction Act of 2022 included limited Medicare drug price negotiation authority — but have not produced the structural changes that PAHCF was formed to prevent.
Whether PAHCF’s activities are the primary cause of those legislative outcomes is not established. The obstacles to single-payer documented in Part 8 of this series — the filibuster, the bipartisan distribution of industry campaign contributions, the lobbying infrastructure across the full healthcare sector — are larger than any single organization. PAHCF is one coordinated element within a broader political environment that has consistently produced the same outcome: no floor vote on comprehensive healthcare reform.
What it has not achieved: Public support for Medicare for All has not declined during the period of PAHCF’s operation. KFF polling consistently finds 65% of Americans supporting Medicare for All, including 49% of Republicans. The coalition’s advertising and messaging activities have not moved that number in the direction its funders would prefer. The twenty-two independent economic studies finding net savings from Medicare for All — including the floor established by the Koch-funded Mercatus Center — continue to be cited by advocates and researchers. The public argument has not been won by the opposition; the legislative outcome has been managed by it.
Current Status
The Partnership for America’s Health Care Future remains active as of 2026. Its website is operational. Its lobbying filings with the federal government continue. Its executive director remains Lauren Crawford Shaver. Its public messaging continues to emphasize building on existing healthcare systems rather than replacing them.
The organization’s activity level has tracked the legislative calendar — most intensive during periods when single-payer or public option legislation was advancing, quieter during periods when those proposals were not actively moving. The 2025 conclusion of the election cycle was noted on PAHCF’s own website as a moment when single-payer was “noticeably missing” from national political discussion — a characterization that reflected the current political moment without addressing the underlying public support the polling consistently documents.
Sources
The Intercept — “Lobbyist Documents Reveal Health Care Industry Battle Plan Against ‘Medicare for All'” (November 2018). Leaked PAHCF planning documents.
The New York Times — “Health Care and Insurance Industries Mobilize to Kill ‘Medicare for All'” (February 2019).
Politico — “AMA drops out of industry coalition opposed to Medicare expansion” (August 2020).
The American Prospect — “Top Democratic Consultants Working for Anti–Medicare for All Campaign” (November 2019).
OpenSecrets — “Healthcare giants attack 2020 Democrats’ healthcare plans with Iowa ad blitz” (August 2019).
Common Dreams — Healthcare advertising spending data, 2019.
LegiStorm — PAHCF lobbying disclosure filings through January 2026.
Wikipedia — Partnership for America’s Health Care Future, organizational history and sourced citations.
Partnership for America’s Health Care Future — organizational disclosures, website, and press materials at americashealthcarefuture.org.
KFF — Medicare for All polling, support by party affiliation.
RAND Corporation — US drug price international comparison, 2022.
KFF — Combined health insurer revenue data, 2025.
MedPAC — Medicare Advantage overpayment, March 2025 Report to Congress.
Sanders.senate.gov — Medicare for All Act, S. 1506, 2025.
This article is supplemental to Part 8 of the series: The Case For and Against Single-Payer Healthcare: What the Research Shows About Costs, Outcomes, and the Path Forward. Part 8 documents the full lobbying infrastructure opposing single-payer reform. This article goes deeper on one specific and named actor within that infrastructure.
The Complete Single Payer Healthcare Series
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