While the health insurance lobby was negotiating with Democrats to limit its exposure during health care reform it was also spending money to defeat health care reform. A lot of money:

Health insurers last year gave the U.S. Chamber of Commerce $86.2 million that was used to oppose the health-care overhaul law, according to tax records and people familiar with the donation. ...
The $86.2 million paid for advertisements, polling and grass roots events to drum up opposition to the bill that’s projected to provide coverage to 32 million previously uninsured Americans, according to Tom Collamore, a Chamber of Commerce spokesman.

It's a smart play -- try to kill the bill, but also negotiate to ensure that you don't get hit too badly if you fail.