In the first half of 2007, the health care sector doled out more than $227 million for lobbying efforts — the first time spending has topped $200 million, according to a tally of semi-annual reports filed with the Senate Office of Public Records.

With Congress’ sharpened focus on health care-related initiatives this year, industry groups have been spending freely to get a piece of the action. The health care industry’s lobby spending has risen year-on-year throughout the decade, but the 17 percent jump is the highest since 2000. And health care interest groups comprised five of the ten highest spending organizations on lobbying in the first six months of the year, a notable change from a year ago, when only two such groups cracked the top ten.

Those five groups — Pharmaceutical Research & Manufacturers of America (PhRMA), American Medical Association (AMA), Amgen USA Inc., American Hospital Association and Pfizer Inc. — saw a $10 million increase in their cumulative spending. PhRMA led the way with $10.7 million in expenditures, with the AMA next with $10.3 million. Amgen’s spending nearly doubled to $9.1 million.

What’s behind health care lobbyists’ spending frenzy? Most signs point to legislation in the House and Senate to reauthorize the State Children’s Health Insurance Program, popularly known as “SCHIP.” It’s the first time Congress has had to reauthorize the program and it’s one of the biggest pieces of health care legislation in the last decade.

Created 10 years ago as a joint federal-state insurance system for low-income children, SCHIP covers about 6 million kids and a few hundred thousand adults and is widely credited with increasing insurance coverage for children. Without congressional action, the program will expire at the end of the fiscal year.

Both Republicans and Democrats said at the start of the session that renewing SCHIP would be a priority, and several lawmakers from each party joined together to offer legislation. But the comity did not last. Meanwhile, the legislation ballooned beyond its original intent as various factions attempted to tack on provisions addressing everything from Medicare payments to rural hospital funding. It generated all sorts of battles between interest groups and kept their lobbyists scurrying.

“SCHIP has really been the vehicle that has gotten the greatest attention from different organizations,” said Ron Pollack, executive director of Families USA, a health-related consumer advocacy group. “There’s always been a question whether that bill would be vehicle for other health care matters, in particular Medicare matters. And key interest groups have a major stake in that.”

Last week, Congressional Democrats were nearing a tentative deal on a final SCHIP package. Lawmakers left town Sept. 12 in a stalemate over a renewal and expansion of the program, but House Democratic leaders made major concessions, including dropping Medicare provisions in the final bill, a condition demanded by Senate Republicans.

Pollack said even those groups without pressing interests in SCHIP legislation have found it prescient to get involved. “I think there’s a growing ethos among the groups that have traditionally been major players in health care that it’s in their interests to appear to be supportive of expanding health coverage, and of course that’s going to be particularly true when you’ve got such a popular constituency like children,” he said.

“Groups that might in the past have stood on the sideline because they felt that the legislation did not have a direct bearing on their interests, have decided, just in terms of currying goodwill  . . .  that they should try to at least to appear to be helpful on expanding coverage,” Pollack said.

But children’s health insurance isn’t the only impetus for groups to expand their 2007 lobbying budgets. Medicare Part D also ranks high on the list of major legislative issues, said PhRMA Senior Vice President Ken Johnson.

“We spent quite a bit of money making people aware of the success Medicare Part D program” earlier this year, Johnson said. PhRMA’s efforts included an ad campaign featuring television and radio ad buys at the national level, as well as in the Beltway and targeted cities across the country.

The change in party leadership in both houses of Congress this past January also has translated into more expenses for lobbying groups.

“Many of the major health care interest groups have worked very closely in the past few years with the Republicans who controlled both houses of Congress and the White House,” said Pollack. “And now that the Democrats are in the majority in the House and Senate and the presidential term is moving towards its close, I think a lot of the interest groups wanted to demonstrate they were more ecumenical and not hostile to the Democrat party position on health care.”

The leadership changes have also meant the new Democratic leadership has been able to pursue a health care agenda that is in many ways more aggressive than their Republican predecessors.

“Anytime there’s a change in leadership there’s going to be a shift in priorities and the new Democratic leadership has made health care a top priority. As a result the issues have been coming at us pretty fast and furious over the past few months,” Johnson said.

Alex Wayne contributed to this story.