Highmark Inc. has spent more than $1.4 million on state lobbying expenses since announcing in March 2007 that it planned to merge with Independence Blue Cross of Philadelphia.

Highmark, Pittsburgh's largest health insurer, has been spending more than a quarter-million dollars every three months, according to its filings with Pennsylvania's Department of State -- $291,500 from April to June 2007, $256,500 from July to September 2007, $307,900 from October to December, and $304,500 from January to March. In the most recent quarterly filing, which covers spending from April to June, it spent $259,904.

Independence Blue Cross, meanwhile, spent more than $963,000 lobbying lawmakers between April 2007 and the last filing. Combined, Highmark and IBC have spent nearly $2.4 million lobbying the state since the merger was announced, according to state records.

The lobbying numbers are fractional compared with Highmark's overall revenue of $12.4 billion in the previous fiscal year. Still, the lobbying money is more than the company spends in direct political campaign contributions, and is a big expenditure in the context of other in-state lobbying efforts.

In the latest quarter, Highmark reported spending less than the statewide doctors' trade group known as the Pennsylvania Medical Society ($321,900) and the Hospital & Healthsystem Association of Pennsylvania ($513,541), natural opponents to Highmark and other insurers on many issues.

But Highmark, a nonprofit, spent more than U.S. Steel, US Airways, UPMC, the University of Pittsburgh, the Pennsylvania State Education Association, the ACLU, Consol Energy, Duquesne Light, PNC Financial Services, Comcast Corp., and most other companies, unions, trade organizations or interest groups.

That's because there is so much at stake for Highmark -- and not just the merger. Insurers were against the state law, approved this summer, that mandates a certain level of insurance coverage for children with autism. Apart from the merger and the autism law, Highmark also lobbied on issues ranging from the statewide smoking ban to a proposed colorectal cancer screening mandate to the reauthorization of the Pennsylvania Health Care Cost Containment Council to universal health care.

"There is increasing concern about rising medical costs, quality of care and access to medical care," said Highmark spokesman Michael Weinstein, and many of those issues manifest themselves on both the state and federal levels. "A significant part of our advocacy efforts are focused on helping legislators understand these and many other complex issues that are helping to shape health-care policy today."

Most of Highmark's lobbying spending goes toward "direct communications" -- meaning the expense that goes into visiting, calling or writing letters to lawmakers and state officials, including the personnel costs attached to those communications. "Indirect communications" are campaigns directed at the public or customers, encouraging them to contact their lawmakers or otherwise take action. On a recent quarterly lobbying report, for example, Highmark said it spent $284,568 on direct communication, $19,607 on indirect campaigns, and $3,733 on "gifts, hospitality, transportation and lodging" for state officials.

Highmark also reported spending $60,000 on congressional lobbying expenses in the second quarter of 2008, plus another $98,000 in spending via its parent group, the Blue Cross Blue Shield Association, according to the Center for Responsive Politics, which tracks lobbying spending and campaign donations. That totals $157,894 in 2008 congressional spending.

In 2007, Highmark reported spending $268,304, all of which was through the parent organization, which essentially hires its affiliates as clients to lobby on a variety of local and national issues. In the same year, Highmark and Blue Cross Blue Shield reported paying Pittsburgh-based Buchanan Ingersoll & Rooney $42,000 to lobby on the Blues' behalf, for a total of $310,000.

The same database says Independence Blue Cross was the beneficiary of $120,000 for congressional lobbying spending in 2007, and $60,000 this year. In total, Blue Cross Blue Shield and its subsidiaries spend $10 million a year or more lobbying Congress on a variety of issues.

Overall, health insurers spent $138 million lobbying Washington last year, helping the larger insurance industry -- auto and home insurers included -- become the second biggest lobbying collective, behind pharmaceutical firms.

Expect that spending to continue to rise as 2009 will bring a new face to the White House and with it a wave of change to the industry. "There's a lot of momentum for health-care reform in this country," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, a lobbying group that has spent two years preparing for what could be a tumult in 2009.

The educational efforts are necessary because "the only way we are going to achieve real heath-care reform in this country is if it has the strong support of the American people," as well as their representatives.

Highmark and IBC are still waiting for the state Department of Insurance to approve the merger, which would create one of the largest health insurers, nonprofit or otherwise, in the country, with revenues in excess of $22 billion. Highmark and IBC publicly pitched the merger in March 2007.