Healthcare industry launched lobbying blitz ahead of year-end spending deal

Major healthcare companies and lobbying groups spent big dollars as they fought to advance their interests on surprise medical billing, Affordable Care Act taxes and prescription drug pricing ahead of a big year-end spending deal, and they mostly got their way.

The American Hospital Association opposed a bipartisan, bicameral compromise on surprise billing that was ultimately left out of the 2020 appropriations package. The group spent more than $6.6 million on lobbying in the last quarter of 2019 according to federal lobbying disclosures, which is $1.2 million more than it spent over the same period in 2018.

The Greater New York Hospital Association, an influential force in Senate Minority Leader Chuck Schumer's (D-N.Y.) home state, spent $620,000 on lobbying in Q4 2019, up $40,000 from the same time period in 2018. Schumer called Sen. Patty Murray (D-Wash.), who negotiated the surprise billing deal, to express his displeasure with the agreement at a key juncture, the Washington Post reported.

"This isn't your typical partisan fight about healthcare. This is really about the business interests of healthcare against the interests of families," said Frederick Isasi, executive director of the consumer advocacy group Families USA.

AHA and GNYHA declined to comment on their lobbying spending.

The branded-drug lobbying powerhouse Pharmaceutical Research and Manufacturers of America spent $6.5 million on lobbying Congress in Q4 2019, and achieved its desired outcome in the year-end spending deal as major, bipartisan legislation to lower drug costs was left out. PhRMA spent $6 million in Q4 2018.

Insurers won some and lost some in the year-end deal—they scored repeals of a health insurance tax and an excise tax on high-cost employer plans that were included in the Affordable Care Act, but the surprise billing deal they supported was left out.

Repeal of the two insurance-related taxes and a 2.3% excise tax on medical devices will cost federal taxpayers nearly $400 billion over the next decade, according to the Congressional Budget Office.

The insurance industry trade association America's Health Insurance Plans spent $2.3 million on lobbying in Q4 2019, up $790,000 from the previous year. The Blue Cross and Blue Shield Association was another big spender at $1.8 million, up $250,000 from its lobbying in Q4 2018. After spending just $320,000 on lobbying in Q4 2018, Humana ramped up its spending in Q4 2019 to $2.9 million.

Physician groups also largely opposed the surprise billing compromise measure. Though the American Medical Association spent a hefty $4 million on lobbying in Q4 2019, the group spent $790,000 less than the same period in the previous year.

Private equity-owned physician staffing companies also beefed up their lobbying operations last quarter. TeamHealth, which is owned by the Blackstone Group, spent $130,000 in Q4 2019. It didn't report any lobbying expenditures in Q4 2018. Blackstone spent $720,000 on its own during the same period in 2019.

Envision Health, a physician staffing company owned by the private equity firm Kohlberg Kravis Roberts & Co., spent $380,000 lobbying in Q4 2019, up from just $80,000 in 2018.

Lawmakers will take another run at addressing drug pricing and surprise medical bills ahead of a self-imposed May 22 deadline to fund expiring Medicare and Medicaid programs.

The deadline for filing lobbying disclosures was Tuesday, Jan. 21, though some lobbying reports are filed after the deadline.