Spending on Health Lobbying Spikes Under Trump

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By Alex Ruoff

Lobbying spending by health and pharmaceutical groups rose significantly in the first months of the Trump administration, according to recent filings.

The Pharmaceutical Research and Manufacturers of America, the largest lobbying group for drugmakers, spent nearly $8 million on lobbying efforts in the first three months of 2017, nearly double its average quarterly spend from 2016 and 2015. The American Medical Association also spent heavily on lobbying, totaling $6.8 million.

Pharma Lobbying

The uptick in spending was likely due to Washington’s health-heavy docket, combined with the start of a new Congress and new administration, health lobbyists, some of whom spoke on condition of anonymity, told Bloomberg BNA. It’s unlikely these groups will continue to spend as much in the next quarter, despite the ongoing debate over repealing the Affordable Care Act.

Overhauling the ACA has dominated the health agenda on Capitol Hill since Donald Trump became president, Jennifer Higgins, a partner and health lobbyist at Chamber Hill Strategies, told Bloomberg BNA. Lawmakers have been so focused on repealing and replacing the health law that they have had little appetite for other health reforms.

“The AHCA in my opinion is this cloud that hangs over health-care policy as long as the president and Republicans want to keep it alive,” Higgins said, referring to the ACA overhaul bill House Republicans are debating.

Republicans in the House have spent much of this year trying to replace the ACA. Lawmakers tried and failed to bring their ACA bill, the American Health Care Act (H.R. 1628), to the House floor for a vote in March and have been debating new amendments to the legislation ever since, hoping the conference can come to agreement.

Reviving the AHCA over and over again with debates over new amendments may keep Congress from moving on to other health issues, such as authorizing new money for CHIP, the public health insurance program for children, and tackling rising drug prices, Higgins said.

Democrats, in some instances working with the Trump administration, have sought to pass drug pricing legislation. Liberals are also largely concerned with defending the health law.

ACA Overhaul

House Republicans, at the urging of the White House, continue to try to pass a bill that would repeal and replace the ACA despite a divide among conservatives over the legislation.

Trump said April 20 he would like the House to vote on a newly revised version of the AHCA before hcr716g2May. Rep. Tom MacArthur (R-N.J.) has proposed changes to the bill he believes can bridge the gap between hard-line conservatives and more moderate members like himself.

Aides to two members of the conservative House Freedom Caucus told Bloomberg BNA they are optimistic the conference will come together under MacArthur’s amendment, which would allow states to waive the ACA’s prohibition on charging people with a history of illness more for plans than healthier individuals if the state creates a system for insuring people with the most expensive conditions.

But moderate Republicans in the House have long said they won’t support a bill that lifts the ACA’s protections for the sick.

Even conservative policy experts are unconvinced.

Michael Cannon, director of health policy studies for the Cato Institute, told Bloomberg BNA the amendment is “unworkable” because it doesn’t also lift the ACA’s age bands, which limit how much insurers can charge older people compared to younger people.

Lobbying Figures

Several health and pharmaceutical lobbying groups spent significantly more trying to influence Congress in early 2017 than they have spent in any three month-period over the past two years, according to lobbying disclosures due April 20.

Lobbyists for drugmakers listed dozens of bills and laws on their lobbying disclosure forms, including the ACA’s annual fee on branded drugs and the medical device tax, the Food and Drug Administration’s user fees and drug importation legislation. Every pharmaceutical group and drugmaker listed the federal budget on their lobbying forums.

PhRMA, which normally spends between $4 million and $5.8 million per quarter, spent $7.98 million in the first three months of 2017. The Biotechnology and Innovation Organization, another drug lobby, spent $2.3 million during the first quarter of 2017, about the same as the previous quarter and the first quarter of 2016.

Drugmaker Novartis spent $4 million, a $3 million rise over the fourth quarter of 2016 and an $850,000 increase over the first quarter of 2016. Pfizer spent $3.7 million, $500,000 more than it did in the first quarter of 2016.

Hospital groups, such as the American Hospital Association and the Federation of American Hospitals, listed the ACA on their lobbying forms. The AMA, which represents doctors, didn’t specifically name the ACA or the AHCA, but has been a vocal opponent of Republicans’ effort to repeal the health law.

Spending by the AHA dipped slightly in the beginning of 2017, to $4.56 million from $4.9 million the previous quarter. The FAH, on the other hand, spent more than it ever has in a single quarter: $1.18 million.

Spending by the largest insurance lobbies, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, remained relatively flat at the beginning of 2017. AHIP spent $1.6 million in the first quarter of 2017, up from $1.3 million in the last quarter of 2016 but down from $2.2 million in the first quarter of 2016.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.

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