The Partnership for America’s Health Care Future is a Washington-based coalition of hospital, health insurance, and pharmaceutical industry lobbyists. It was formed in 2018 with one documented purpose: to prevent Medicare for All, the public option, and any structural reform to the American healthcare system from advancing.
It spent $60 million in two years. It ran 40 million Facebook and Instagram impressions. It hired the firms that run Democratic campaigns to run its campaign against the Democratic Party’s most popular healthcare proposal. It ghostwrote op-eds for state legislators and then cited them as evidence of organic opposition. It followed reform to Colorado and Connecticut when the federal window closed and outspent every organization in Colorado lobbying history to strip the public option from state legislation.
A peer-reviewed study published in July 2025 found that its tactics directly mirrored the strategies the tobacco industry used to manufacture doubt about the health effects of smoking.
This series documents how it works — in full operational detail. Each article stands alone. The complete series is the most thorough power map of organized healthcare industry opposition available on this platform.
The Series
01 — What It Is and Why It Exists
The founding story, the legal structure that conceals its funding by design, and the thirty-year strategic lineage that connects PAHCF to the “Harry and Louise” campaign against the Clinton healthcare plan and the negotiation that removed the public option from the Affordable Care Act. The same person. The same strategy. Three decades of application.
02 — Who Funds It and What the Money Buys
The money trail as far as investigative reporting has been able to surface it from a structure specifically designed to prevent surfacing. CVS Health: $5 million. Tenet Healthcare: $2.1 million. Six contributions of $5 million each documented in tax returns without donor identification. $60 million total in two years. The contrast: 266,000 individual donors to AOC’s campaign at an average of $21.
03 — The Federal Strategy
How the coalition shaped which candidates adopted which positions before anyone reached Congress — by hiring the firms that run Democratic campaigns to run its opposition campaign. The pollsters working with Biden’s campaign and the DCCC simultaneously tested attack lines against Medicare for All for PAHCF. The consultants working with the DNC simultaneously ran PAHCF’s digital strategy. The candidate did not need to be lobbied directly. The environment had been constructed.
04 — Manufacturing Grassroots
The ghostwriting operation: PAHCF lobbyists drafted op-eds for state legislators in Montana and Ohio, who published them without disclosing the drafting relationship. The lobbyist edited out three paragraphs in a Montana Democrat’s draft that accurately documented US per capita healthcare spending — because the facts complicated the argument. PAHCF then cited the resulting columns as evidence that “voices throughout the nation” independently opposed Medicare for All.
05 — The State Battlefield
When the federal legislative window closed, the operation redeployed. In Colorado in 2021, PAHCF spent more on lobbying than any organization in the state’s recorded history — resulting in the removal of the actual public option from state legislation. In Connecticut, five health insurance companies threatened to leave the state if the public option passed. The continuous operations model does not stand down when a specific reform is defeated. It follows reform wherever it surfaces.
06 — The Tobacco Playbook
The strategic lineage behind every tactic documented in this series — from the tobacco industry’s manufacture of scientific uncertainty to PAHCF’s manufacture of public doubt about healthcare reform. The current landscape: 63 percent public support for Medicare for All even on the hardest available framing, 111 House co-sponsors, 261,000 people at Fighting Oligarchy events. PAHCF’s reduced visible activity in 2025 and 2026. And the open question the series cannot answer: whether the civic side builds something durable enough to matter before the next time the PAHCF operation runs at full capacity.
Related Analysis
The Organized Interests Playbook: A Structural Analysis of PAHCF
The same twelve-strategy framework applied to BDS, Black Lives Matter, and the Pro-Life and Pro-Choice movements applied to PAHCF — the first Analysis section entry that examines the organized interests side rather than the civic side. What the framework reveals about how the organized interests side uses the same tools as civic organizations, more systematically, with greater resources, and without the accountability constraints that operating in public creates.