Medical interests alone shelled out more than $876 million in lobbying expenses during the 15 months beginning in January 2009 and ending in March, when Congress passed the sweeping overhaul.
Those stakeholders, including the drug industry, doctors, hospitals and manufacturers of medical products, were responsible for one out of every five dollars doled out on lobbying during that period, according to a CQ MoneyLine analysis of lobbying disclosure reports filed with Congress.
While health care has historically been an issue that has drawn intense lobbying, even some veterans of Capitol Hill expressed astonishment at the big bucks lavished during the 15-month slog.
That is an astounding amount of money, said Ralph Neas, president of the National Coalition on Health Care, which pushed for passage of the overhaul. Neas, who began his career in Washington in the 1970s as an aide to then-Sen. Edward Brooke (R-Mass.), said that in his time here, I cant think of anything that remotely comes close to that amount of lobbying.
But there was much at stake for medical interests as lawmakers put together the bill, which will affect millions of Americans and their employers in the years ahead.
This is the most important domestic legislation in at least 45 years, Neas said, referring to the creation of Medicare and Medicaid in the mid-1960s.
Tony Podesta, president of the Podesta Group, which ranked second among K Street firms in fees paid to work on health care reform during this period, said lobbying on the issue is far from over.
Podesta said his firm was still picking up clients with a stake in how the measure is implemented and in any corrections Congress might make. Even companies that are not directly involved in health care are affected by the new law, which includes corporate tax changes related to retirees health benefits, sets up insurance exchanges and mandates all individuals purchase health insurance.
We just did a briefing for non-health care clients on the bill, Podesta said. We had really good attendance.
Prescription for Reform
Within the health care industry, drug companies racked up the biggest lobbying tab, spending $253 million. They were followed by hospitals, which spent $108 million, and doctors and surgeons, who spent $59 million.
Thomas Mann, a political scholar at the Brookings Institution, said one difference between this health care push and the last time the issue came up, during the Clinton administration, was that many in the health care industry supported the overhaul legislation.
A good percentage of that lobbying budget was spent on behalf of reform, Mann said.
Indeed, the drug companies, led by the Pharmaceutical Research and Manufacturers of America, early on reached a deal with Democrats that involved providing tens of billions of dollars in drug subsidies for seniors. In return, name-brand drug companies protected their right to exclusively market groundbreaking biologic drugs over a 12-year period.