2. Karen Ignagni
After killing health care reform in 1993, the health insurance lobby made the PR-savvy decision not to come out in staunch opposition to the Democrats’ plans this year. But that doesn’t mean the powerful industry and Ignagni, president and CEO of America’s Health Insurance Plans, haven’t won almost everything they wanted from the legislation. Indeed, Senate leaders dropped the public insurance option; scrapped the provision eliminating the industry’s federal anti-trust exemption; and included an individual coverage mandate that will result in millions of new customers for the private companies. On top of that, the insurers are poised to receive more than $430 billion in federal subsidies in the next decade alone. Not a bad deal by any industry standard.