The Hartford, Conn., health insurer trimmed its spending 34 percent from the $1.6 million it spent in the same quarter last year, when Congress debated and then ultimately passed the overhaul, which aims to cover millions of uninsured Americans but also imposes a host of restrictions on insurers. Compared with the final quarter of 2010, Aetna bumped up its spending 9 percent from $998,150.

The insurer kept a strong focus on the overhaul in this year's first quarter as well. It lobbied on a House of Representatives bill that called for the overhaul's repeal. It also lobbied on bills that directed the U.S. Supreme Court to expedite consideration of the constitutionality of the overhaul and another resolution that instructed committees to develop proposed alternatives to it, according to a report filed on April 12 with the clerk of the House of Representatives.

Aetna also lobbied on a bill that would allow the Department of Health and Human Services to directly negotiate drug prices, another that would allow for the cross-state purchase of insurance coverage, and it lobbied on the Medicare Advantage open enrollment period and medical malpractice liability reform.