# Blue Cross Blue Shield Association The federation of Blue Cross and Blue Shield insurers, whose aggregate federal lobbying — **$28.0M in 2025 (#6)** across the association and affiliates — makes the Blues one of the biggest single voices on health-insurance policy: ACA marketplace rules, Medicare Advantage, and PBM fights. Listed in the [[Lobbying Hub]] demand-side table (2025 top-20 spenders). *Status: stub — expand with leadership, political history, and current policy fights.* ## See also [[Lobbying Hub]] · [[Trade Association]] · [[Lobbying]]