Health Care Lobbying Rose 70% in 20 Years

Lobbying spending by the health care industries reached $713.6 million in 2020, a 70% increase over the past two decades, according to a recent JAMA Health Forum analysis based on data compiled by OpenSecrets. The growth was mainly driven by pharmaceutical and health product manufacturers and providers. Expenditures were highly concentrated among a small subset of firms, especially for payers, with the top 10% of health plans responsible for 70.4% of spending.


Health plans’ lobbying contributions have increased steadily over the past decade. Meanwhile, the spending of several major plans during the first three quarters of 2022 has surpassed the amount they spent as of the same time last year. Blue Cross Blue Shield plans spent nearly $20.6 million on lobbying, with Elevance Health, Inc. spending the most ($5.2 million) as of the third quarter of 2022.


Since 2016, the health services/HMOs industry, which traditionally gives more to Republicans, has shifted to distribute more campaign funds to Democratic lawmakers. During the 2021-2022 election cycle, around 60% of funds were donated to Democrats. Among the major health plans, UnitedHealth Group, Blue Cross Blue Shield, Humana Inc. and Molina Healthcare donated nearly evenly to the two parties, whereas Centene Corp. and Kaiser Permanente gave the majority of their contributions to Democrats.


Among the top 20 lawmakers who received the most contributions from the health services/HMOs industry during the 2021-2022 election cycle, 11 are Democrats, with Charles Schumer of New York topping the list ($606,918).


NOTES: Providers are defined as health professionals, hospitals, nursing homes and associated trade organizations; other, as health care consultants and policy organizations. All donations took place during the 2021-2022 election cycle and were released by the Federal Election Commission on Oct. 28, 2022.

SOURCES: Open Secrets. “Lobbying Expenditures in the US Health Care Sector, 2000-2020,” JAMA Health Forum. 2022;3(10):e223801. doi:10.1001/jamahealthforum.2022.3801.

This infographic was reprinted from AIS Health’s weekly publication Health Plan Weekly.

Jinghong Chen

Jinghong Chen Reporter

Jinghong produces infographics and data stories on health insurance and specialty pharmacy for AIS Health. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting. Before joining AIS in 2018, she worked at WBEZ, Al Jazeera English and The New York Times Chinese.

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