The six largest publicly traded health insurers and two large health insurer trade groups spent a total of $7.7 million during the first quarter on federal lobbying, according to Health Care for America Now.

HCAN, Washington, a group that supported efforts to pass the bills that make up the Affordable Care Act – the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act – says the $7.7 million total, drawn from the congressional filings in the Lobbying Disclosure Act Database, includes only expenditures on federal lobbying.

The total does not include lobbying at the state level, public relations campaigns, or funding of groups that purport to represent consumers, workers or other groups but really represent health insurers, HCAN says.