Oct 28, 2022 - Health

Health care industry spending on federal lobbying surged 70% over 20 years

Illustration of a first aid bag filled with cash.

Illustration: Aïda Amer/Axios

Health industries' spending on federal lobbying rose 70% from 2000 to 2020, largely driven by drug and device makers and activities surrounding the Affordable Care Act, according to new research in JAMA Health Forum.

Why it matters: A small number of firms spent disproportionate sums on lobbying, which researchers said could lead to some constituencies being underrepresented in policymaking.

What they found: The industry as a whole spent $713.6 million lobbying federal policymakers in 2020, compared to $358.2 million in 2000. Drug and device manufacturers accounted for about 43% of the total in 2020, or $308.4 million.

  • Growth on spending was steeper in the early 2000s, as players adjusted to the ACA and tried to influence its implementation.
  • Spending was highly concentrated, with the top 10% of firms accounting for 70% of lobbying outlays among payers, 69% among manufacturers and 59% among providers, researchers found.

Background: Drugmakers and hospitals have been among the top five overall spenders on lobbying for nearly a quarter of a century, according to OpenSecrets, which tracks money in politics.

  • Seven of the top 10 organizations registered to lobby on the Inflation Reduction Act — out of more than 2,000 total — were pharmaceutical or health insurance companies.
  • PhRMA, the big drug industry lobby, has wielded the most power within the health care sector since 2017, according to OpenSecrets. It broke records on spending during the political battle over drug prices.
  • In 2021, health care companies spent nearly $700 million on lobbying, the highest ever reported in a single year.

Details: Researchers broke up industry players into four categories: drug and device makers; providers like hospitals and physicians; insurers and other payers, and health care consultants and other policy organizations.

  • The research was derived from mandated federal reporting thresholds that don't reflect every dollar put toward lobbying, and not all firms report spending tied to state-level efforts.
Go deeper