Despite a furor over allegations that House Majority Leader Tom DeLay and a long-term-care lobbying group violated campaign-finance laws, the GOP healthcare agenda continues to move forward and healthcare lobbying efforts and tactics are expected to remain as aggressive as they have been, experts said.
On Sept. 27, the Texas Republican was indicted by a grand jury in his home state for allegedly funneling corporate funds "with the intent that a felony be committed," said the indictment. His indictment, along with those of two associates, follows indictments last year charging the Alliance for Quality Nursing Home Care and seven companies with making illegal contributions to a political action committee created by DeLay.
But even as last week's development put DeLay's political future in jeopardy, Washington experts said that his temporary forfeiture of the leadership position and the naming of Rep. Roy Blunt (R-Mo.) as majority leader doesn't signal changes in Congress' healthcare plans.
"We don't expect the Republican agenda to change," said Alicia Mitchell, a spokeswoman for the American Hospital Association. The GOP agenda includes changes in Medicaid and malpractice liability, and a push for association health plans.
Similarly, she and representatives from other national healthcare lobbying organizations said the charges leveled against the Alliance for Quality Nursing Home Care, a lobbying group for for-profit long-term-care companies, will not change the way the groups operate.
"It does not change our agenda. We're going to continue working with both parties," said Susan Feeney, a spokeswoman for the American Health Care Association and the National Center for Assisted Living, which lobby on behalf of long-term-care facilities.
At issue is whether DeLay and his political action committee, Texans for a Republican Majority, accepted illegal corporate contributions, then directed the funds to Republicans who ran for state office in 2002. Texas law does not allow corporate funds to be used for state election purposes.
That year 17 Republicans who received funding from the committee were elected, giving Republicans control of the state House. That in turn allowed Republicans to redraw Texas' congressional districts, which led to the party gaining seats in Congress.
While Texas law bars companies from contributing to a candidate's election war chests, it does allow corporate contributions in some instances, such as to offset administrative costs for political action committees. According to Texas prosecutors, though, the nursing home alliance's contribution did not fall into any of the categories for which contributions are allowed.
The alliance, which lists 16 members on its Web site, contributed $100,000 to the Texans for a Republican Majority political action committee, prosecutors allege. Of the eight indicted a year ago, the nursing home alliance made the biggest contribution. The alliance denies any wrongdoing.
"At the time the check was issued, it was certainly the expectation of the alliance that the funds would be used for lawful purposes," said Greg Waller, a Houston lawyer representing the group.
Andrew Wheat, research director for Texans for Public Justice, however, said that the sheer amount of the donation, given in one check, raises questions. The organization is a not-for-profit campaign reform group.
"It's a huge amount of money ... It's clear the nursing homes had an agenda," he said.
In 2003, legislation that capped damages at $250,000 for accidents that occur in nursing homes passed the state Legislature, said Tom Smith, director of Public Citizen's Texas office. The legislation also loosened the nursing home inspection process, he said.
"Clearly, this is a precursor to having the $250,000 cap on a national basis," Smith said about the alliance's donation to the PAC. "This is a model of bad policy."
In Texas, the healthcare industry has been increasingly generous with its political contributions. A search of state races in Texas last year shows that hospitals and nursing homes spent $320,170 on campaign donations.
But in 2002, the number was even greater. During 2002's heated gubernatorial race, the industry donated a little more than $1 million in election-year contributions, according to data gathered by the Institute on Money in State Politics.
Joe DaSilva, senior vice president for advocacy and public policy at the Texas Hospital Association, said that while he doesn't specifically track the issues for which the alliance lobbies, political donations from the Texas healthcare industry have reached record levels.
"With each passing year the involvement is greater and greater, both at the federal level and obviously at the state level," DaSilva said. The Texas Medical Association is one of the top three donors at the state and federal level, he said, adding that the nursing home industry is not far behind.
In 2004, Elmer Ellis, president and chief executive officer of the East (Tyler) Texas Medical Center Regional Healthcare System was tagged by the Internal Revenue Service for allegedly forcing employees to contribute to the THA's political action committee. The hospital system admitted no wrongdoing but paid $300 in excise taxes for illegally participating in political campaigns (June 27, p. 48).
Despite the DeLay controversy, many expressed skepticism that the scandal would lead to widespread changes. Mary Boyle, a spokeswoman for Common Cause, a nonpartisan advocacy group that champions transparency in government, said that it's too early to gauge whether DeLay's indictment may stem further political donations by healthcare lobbyists. All indications are that it won't.
The pharmaceutical and healthcare industries are "some of the most prolific lobbyists and donors on Capitol Hill," Boyle said. "If it has an effect, it is yet to be seen. Maybe it will give some industries pause for a few minutes before it's back to business as usual."
Meanwhile, the change in House leadership is not expected to affect how Congress approaches healthcare issues. The Republican agenda has already been set and Chip Kahn, president of the Federation of American Hospitals, a lobbying group representing for-profit hospitals, said the House majority leader leaves it to committee chairs to fulfill that agenda.
Rep. Bill Thomas, (R-Calif.), chairman of the House Ways and Means Committee, said in a written statement he will continue on the political agenda laid out by DeLay. A spokesman for Rep. Joe Barton, chairman of the House Ways and Means Committee, said there are no changes to its healthcare agenda.