Lobbyist spending across the healthcare sector increased by more than 70% from 2000 to 2020 after adjusting for rising prices, according to a recent peer-reviewed analysis.
The lobbying dollars were spread across multiple segments of the industry, though increases among pharmaceuticals/health product manufacturers and then healthcare providers accounted for the lion’s share, researchers from Cornell Medical College and the University of Pennsylvania wrote in JAMA Health Forum.
The acceleration of spending was greater in the 2000s than during the 2010s, “in part because of lobbying efforts targeting the Affordable Care Act,” researchers wrote.
The team also highlighted the “disproportionate amount” spent by a small handful of firms, “which may lead to certain constituencies being underrepresented in the policy-making process.”
“Little is known in the health policy literature about the amount spent on health care lobbying outside the pharmaceutical and health products industry,” the researchers wrote in the journal. “Other healthcare stakeholders, such as hospitals and insurers, have faced regulatory scrutiny and may be investing in lobbying activities to represent their interests.”
The team reviewed two decades of federal lobbying activities as recorded by OpenSecrets, a nonprofit and nonpartisan group that tracks the reports that firms are required to file once quarterly spend hits certain monetary thresholds.
Researchers sorted the recorded health sector lobbying expenditures into four separate industry categories—pharmaceutical/health product manufacturers, payers, providers and other (consultants and policy organizations)—and adjusted all spending totals to 2020 dollars using the Consumer Price Index.
Healthcare lobbying increased from $358.2 million in 2000 to $713.6 million by 2020, according to the study. By the study period’s end, $308.4 million came from pharmaceutical/health product manufacturers, $286.9 million from providers, $80.6 million from payers and $37.7 million from other firms.
Among those 2020 funds, researchers noted “highly concentrated” spending among each segment’s top 10% of firms. The top decile of lobbyists was responsible for 70.4% of the reported lobbying expenditure from payers, 69% of manufacturers, 59% of providers and 37.7% of the other firms.
The group noted that their report doesn’t include lobbying expenditures underneath the mandatory reporting thresholds or the minority of firms that also spend at the state or grassroots level.
Per OpenSecrets, the lobbying industry as a whole went on to hit an all-time high of $3.7 billion in 2021, a 6% increase over the previous year. This included $361.1 million from manufacturers, $159.4 million from providers, $89.6 million from payers and $7.1 million from other miscellaneous groups, according to the nonprofit.