It’s wrong to state this as a binary. This isn’t mutually exclusive and all of the parties profiting from the status quo had a common interest in preventing ref

It’s wrong to state this as a binary. This isn’t mutually exclusive and all of the parties profiting from the status quo had a common interest in preventing reforms - those don’t overlap perfectly so the groups fissured on different lines but they lobbied independently and as part of joint groups like this one: https://en.wikipedia.org/wiki/Partnership_for_America%27s_Health_Care_Future https://en.wikipedia.org/wiki/Partnership_for_America%27s_He... There are significant generational issues, too. For example, older doctors who owned highly profitable private practices took a very different position from younger doctors who are employees of huge companies, and the pharmaceutical lobby wasn’t opposed to the ACA as long as it didn’t involve cutting their profit margin to what Medicare or the VA pay.