Lobbyist spending on healthcare grew 70% in 20 years, research finds

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In the 20-year period from 2000 to 2020, lobbyist spending in healthcare increased by more than 70%, even after accounting for inflation, with a large amount of that spending focused on pharmaceuticals and healthcare providers, according to new data published in JAMA Health Forum.

Using OpenSecrets, a nonprofit, nonpartisan organization that tracks money in politics, researchers honed in on four broad categories: pharmaceutical and health product manufacturers; providers (health professionals, hospitals, nursing homes, and associated trade organizations); payers (insurers and health maintenance organizations); and other (healthcare consultants and policy organizations).

Lobbying expenditures grew across all four categories, with higher levels of growth seen prior to 2010.

In 2020, healthcare lobbying expenditures totaled $713.6 million, vs. $358.2 million in 2000. In 2020, pharmaceutical and health product manufacturers spent the most on lobbying activities ($308.4 million), followed by providers ($286.9 million), payers ($80.6 million), and other firms ($37.7 million).

Spending was highly concentrated, with the top 10% of firms responsible for 70.4% of spending among payers, 69.0% among manufacturers, and 59.0% among providers.

Spending among other firms was less concentrated, with the top 10% responsible for 37.7% of spending.


The findings reveal that spending from pharmaceutical and health product manufacturers and providers, including their associated trade organizations, comprise the majority of lobbying expenditures from the healthcare sector.

Lobbying activities also were not distributed uniformly, with a small number of firms responsible for the majority of expenditures.

Growth on spending was steeper in the early 2000s relative to more recent years, in part because of lobbying efforts targeting the Affordable Care Act. A minority of firms spend a disproportionate amount on lobbying, which may lead to certain constituencies being underrepresented in the policy-making process, authors said.

Lobbying activities in the US health care sector have drawn increasing public scrutiny over concerns that some firms may be wielding an outsized influence on policy making, authors said.  Other healthcare stakeholders, such as hospitals and insurers, have faced regulatory scrutiny and may be investing in lobbying activities to represent their interests.


JAMA researchers cautioned that the study may not reflect all lobbying expenditures. And although the majority of firms only report expenditures associated with federal lobbying, some also include state-level and grassroots lobbying in their mandated disclosures.

Distinguishing spending by firms with both healthcare and non–healthcare lines of business was not always possible, the report notes. OpenSecrets data, however, has been validated and used for research across multiple sectors of the economy.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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