“We don't make widgets,” said Dean Rosen, a partner with Mehlman Castagnetti Rosen Bingel & Thomas who was chief healthcare adviser to then-Senate Majority Leader Bill Frist (R-Tenn). “It's a lot about who you know and what you know.”
Among the healthcare interests that hire lobbyists, the pharmaceutical and device industries, whose core interests involve the FDA for regulatory approvals and the CMS for reimbursement, represent the largest share. Last year, those companies spent at least $226 million on lobbying, according to the Center for Public Integrity. The biggest player: PhRMA, which spent about $30 million.
Among individual pharmaceutical firms, Eli Lilly & Co. spent the most money seeking to influence policy in Washington, with nearly $12 million in expenses. Pfizer followed close behind, with $11.5 million in lobbying expenditures last year.
Hospitals and nursing homes accounted for the second-largest share of healthcare lobbying expenses last year, with at least $92 million in expenditures, according to the CPI. The American Hospital Association, the largest industry group, was the dominant player, with $18.8 million in lobbying expenses. The Federation of American Hospitals, which represents the smaller for-profit hospital sector, spent less than a quarter of that amount.
Among individual providers, Select Medical Holdings had the biggest presence on Capitol Hill, racking up $4.1 million in lobbying expenses. That was followed by Kindred Healthcare ($2.8 million), Partners HealthCare ($2.1 million) and the UPMC health system ($2 million).
Organizations that represent health professionals spent at least $85 million on lobbying last year. The American Medical Association accounted for more than 20% of that amount, with $18.5 million in lobbying expenses. The other top professional organizations in terms of lobbying expenses last year were the American College of Radiology ($4.1 million), the American Dental Association ($3.4 million) and the American College of Emergency Physicians ($2.9 million).
Insurance companies racked up more than $70 million in lobbying costs in 2013. The main industry group—America's Health Insurance Plans—was the biggest spender, with $11.5 million in expenses. The Blue Cross and Blue Shield Association was close behind, with lobbying expenses of $10.9 million last year. Among individual plans, WellPoint was the biggest spender, with $6.2 million in expenditures.