Billionaire libertarian activist David Koch died Friday, removing a major funding figure from the healthcare political scene.
But the passing of the 79-year-old co-founder of the right-wing advocacy group Americans for Prosperity likely will have little impact on continuing efforts by that group and his brother Charles Koch on healthcare issues.
Charles is generally seen as the driving force behind the family's formidable political funding and advocacy efforts, while David was the folksy and genial front man and spokesman.
David Koch, who had reported assets of $42.2 billion in 2019 and owned a 42% stake in his family's giant conglomerate Koch Industries, had battled prostate cancer for nearly three decades.
He donated large sums to medical and scientific research, including $100 million to a new cancer research facility which opened in 2011 at Massachusetts Institute of Technology, his alma mater.
But he was more widely known for his and his brother's political advocacy efforts through Americans for Prosperity and funding of conservative political candidates at the state and federal level.
"The Koch-financed network of groups in the first half of this decade certainly was a substantial factor in amplifying and organizing opposition to Obamacare and strengthening state-level resistance to expanding Medicaid and implementing state-administered health insurance exchanges," said Thomas Miller, a conservative health policy analyst at the American Enterprise Institute.
The brothers co-founded the not-for-profit AFP in 2004, and also heavily supported and funded the American Legislative Exchange Council, an organization of conservative state lawmakers and lobbyists that has drafted model state laws that have been passed in many states.
The Koch network has spent huge sums to support conservative Republican candidates, shelling out nearly $900 million in the 2016 election cycle, much of it in so-called dark money contributions that aren't publicly reported.
David and Charles Koch have had enormous influence in shifting the Republican Party rightward on healthcare and other issues by funding right-wing primary challenges for congressional and state legislative seats. That has discouraged more moderate GOP lawmakers from supporting popular healthcare programs such as Medicaid expansion.
Their network also provided key logistical support for the Tea Party movement, which was a powerful force working to block the Affordable Care Act.
The Koch brothers' network organized a relentless campaign against the ACA after it was passed in 2010. It reportedly spent $200 million to stymie the law.
The AFP and its Tea Party allies were the key actors in many states like Kansas in successfully lobbying against Medicaid expansion.
"The Koch brothers' role in Medicaid expansion, to my eyes, has been destructive," said Andy Slavitt, the acting CMS administrator in the Obama administration. He said the Koch-backed AFP often dispatched conservative organizers and activists to states considering Medicaid expansion to dissuade Republican state lawmakers from approving expansion.
"They work to make it harder for marginal-income people to get basic care," Slavitt added.
Ironically, the brothers' financing and backing of ultraconservative House Republicans known as the House Freedom Caucus inadvertently may have thwarted their campaign to repeal the ACA in 2017. Many Republicans blamed caucus members' insistence on completely abolishing the ACA for their party's ultimate failure to pass any repeal-and-replace legislation.
David and Charles were lifelong libertarians who learned their distrust of government programs from their father, Fred, a founding member of the John Birch Society. David said he strongly believed that small government produced greater prosperity and freedom.
"It's something I grew up with, a fundamental point of view that big government was bad, and imposition of government controls on our lives and economic fortunes was not good, he said in an interview published in Reason magazine.
He ran in 1980 as the Libertarian Party's vice presidential nominee, on a platform calling for the abolition of Medicare and all corporate and personal income taxes.
His death is not expected to affect the continuing efforts of his brother, the Koch network, and the AFP to work against government healthcare, the American Enterprise Institute's Miller said.
He predicted that if the 2020 election debate focuses on Medicare for all or a public health plan option, Koch-affiliated groups will fight hard against those proposals.
Americans for Prosperity did not respond to a request for comment.
