Top 25 lobbyists by spending: Who spent on healthcare issues in 2016

More than 11,000 organizations spent $3.12 billion on lobbying the federal government in 2016 — the lowest amount spent since 2007, according to the Center for Responsive Politics, a nonprofit, nonpartisan research group. However, spending on the Hill is expected to pick up again under the Trump administration as it grapples with controversial issues like the ACA repeal and replacement, according to a CRP blog post.

Despite lower overall spending, organizations from the healthcare industry accounted for the greatest share of spending by any industry in 2016. About 16 percent of total lobbying spending — or more than $509 million — was paid for by healthcare organizations last year, according to CRP. This is roughly on par with spending by healthcare organizations in 2015, when they shelled out $513 million.

Unfortunately, due to the nature of the way lobby data is reported, spending cannot be broken down by issue, according to MapLight, a nonpartisan research organization. This means it is not possible to see how much was spent on specific health issues. However, it is possible to approximate which organizations may have had the largest financial influence on health issues based on which lobbyists spent most in 2016 and also channeled some of those funds toward health issues.

MapLight provided Becker's with the following breakdown of organizations that spent the most lobbying the federal government in 2016 and spent at least some of those funds lobbying on health issues; medical research and clinical labs; Medicare and Medicaid; and/or pharmaceuticals.

Note: Dollar amounts reflect totals spent lobbying across all issues, healthcare or otherwise, by each organization in 2016.

1. U.S. Chamber of Commerce — $75.52 million
The U.S. Chamber of Commerce lobbied on health issues in 2016. Their focus included bills to repeal the tax on payers under the ACA and repeal the tax on medical device manufacturers, as well as the 21st Century Cures Act and the World's Greatest Healthcare Plan Act, an ACA replacement plan put forth by Sen. Bill Cassidy, MD, R-La., and Rep. Pete Sessions, R-Texas.

2. National Association of Realtors — $52.72 million
This trade association for real estate agents lobbied on health issues, particularly the Equity for Our Nation's Self-Employed Act, which would make health insurance premiums tax-deductible for those who are self-employed.

3. U.S. Chamber of Commerce Institute for Legal Reform — $27.71 million
The Institute for Legal Reform, an affiliate of the U.S. Chamber of Commerce that advocates for tort reform, lobbied on Medicare, Medicaid and health issues in 2016. These issues included the 21st Century Cures Act, regulations to strengthen Medicare anti-fraud measures and issues related to Medicare Secondary Payer reporting requirements.

4. Pharmaceutical Research & Manufacturers of America — $19.62 million
PhRMA, a pharma trade group, lobbied across the board on health issues, Medicare, Medicaid, pharmacy, medical and disease research and clinical labs. The issues they supported included provisions of several bills related to funding for the National Institutes of Health, antibiotic drug approval for limited populations, patient-focused drug development, drug importation issues and opioids.      

5. American Hospital Association — $18.83 million
The AHA lobbied on the 21st Century Cures Act, issues related to oversight of surgical practices, hospital reimbursement, health IT transparency, unique device identifiers, improving care for patients with chronic diseases and a bill that would remove the 96-hour physician certification requirement for critical access hospital payments.

6. American Medical Association — $18.77 million
The AMA reported lobbying on meaningful use, the Medicare Access and CHIP Reauthorization Act, Zika funding, Stark Law modernization, opioid addiction treatment and 21st Century Cures.

7. Boeing — $17.02 million
The aerospace giant lobbied on the Cadillac tax, an excise tax on high-cost employer health plans; the ACA's reinsurance fee for health plans; as well as employer benefit issues, transparency, delivery reform and cost containment, among other issues.     

8. Business Roundtable — $15.7 million
Business Roundtable is a lobbying association made up of CEOs from leading companies around the country. The group lobbied on issues related to the repeal and replacement of the ACA, the Cadillac tax and the GOP-led House Health Care Task Force "A Better Way" project, among other issues.

9. Google — $15.43 million
Google lobbied on advanced sensor-based technologies, health IT and health data policy in 2016.

10. Dow Chemical Company — $13.44 million
Dow lobbied on health reform proposals like the Cadillac tax, health IT issues and employer wellness programs. It also lobbied on the Employee Retirement Security Act, which regulates employee and retiree health benefits, as well as the House Better Way plan.

11. General Dynamics — $10.74 million
This aerospace and defense corporation lobbied on fiscal year 2017 funding for CMS call centers and issues related to health IT for HHS.

12. Verizon Communications — $10.08 million
Verizon, a telecommunications company and wireless service provider, lobbied on health issues related to telemedicine, including bills to allow for interstate care for Medicare patients and veterans via telemedicine, as well as the Cadillac tax and other changes to employer-sponsored healthcare.

13. Altria Group — $10.06 million
This tobacco corporation lobbied last year on MACRA, Medicare Secondary Payer responsibility, the CDC's implementation of healthcare funding provisions under the ACA, fees for tobacco manufacturers that fund Food and Drug regulation costs and issues related to the predicate date for tobacco products and e-cigarettes under the Tobacco Control Act.

14. Amgen — $9.86 million
Amgen, a biopharmaceutical company, lobbied on issues related to former Vice President Joe Biden's Cancer Moonshot Initiative, proposed Medicare and Medicaid cuts, Medicare Part B pricing, the 21st Century Cures Act and provisions of other bills related to incentives for innovation to expedite the development and approval of drugs, among other issues. 

15. Pfizer — $9.75 million
This pharmaceutical corporation lobbied on health issues, Medicare, Medicaid and pharmacy in 2016. Pfizer lobbied to increase funding for the CDC National Immunization Program, and lobbied on MACRA, 21st Century Cures and Medicare Part D reimbursement issues.

16. American Bankers Association — $9.31 million
The ABA, a banking trade association, lobbied on health savings accounts, high-deductible insurance plans and related issues under the ACA in 2016.

17. Biotechnology Industry Organization — $9.23 million
This biotechnology trade organization lobbied on a wide range of healthcare issues including Medicare, Medicaid, pharmacy, medical and disease research and clinical labs. Specifically, it lobbied on the 21st Century Cures Act, funding for CDC vaccine programs, the Medicare 340B Drug Pricing Program and other legislation related to drugs and biologics.

18. Prudential Financial — $9.11 million
Prudential — an insurance, investment management and financial services company based in Newark, N.J. — lobbied on D.C. Healthcare Exchange fees.

19. AARP — $8.71 million
The AARP, a interest group for retirees, lobbied on healthcare issues for seniors including Medicare and Social Security; advocated for limited age rating for private health insurance; and among other issues, supported the FAIR Drug Pricing Act, a bill that would require drug manufacturers to report price increases if they exceed a 10 percent increase over 12 months.

20. General Motors — $8.5 million
GM lobbied on general issues related to ACA implementation, the Cadillac tax and the Save American Workers Act of 2015, which changes the average weekly hourly requirements for a full-time employee under the ACA's employer mandate from 30 hours per week to 40 hours per week.

21. National Association of Manufacturers — $8.49 million
The NAM represents approximately 14,000 manufacturing companies across industries. Last year, it lobbied on ACA implementation, Medicare Advantage, Medicare Part D, drug price transparency and a bill that called for the repeal of the ACA's Independent Payment Advisory Board, which was created to develop proposals to reduce Medicare spending growth.

22. Blue Cross Blue Shield Association — $8.43 million
BCBSA, which represents independent BCBS plans around the country, lobbied on an array of healthcare issues in 2016. Some of those issues included the Cancer Moonshot Initiative, legislation to address the opioid epidemic, the ACA's risk corridor program, health savings accounts, ACA reform and the GOP replacement plan, A Better Way.

23. Coca-Cola Company — $7.93 million
Coca-Cola lobbied on calorie transparency and obesity prevention; issues related to Nutrition Facts Panel changes; and legislative monitoring related to agriculture, sustainability, beverage industry and health and wellness.

24. Bayer — $7.75 million
This pharmaceutical company lobbied the FDA in 2016 on legislative and regulatory issues on product review and approval. It also monitored legislative and administrative actions on drug importation, drug shortages, the 340B Drug Pricing Program, medical supply access, women's health issues and over-the-counter drugs, among other items.

25. Oracle — $7.65 million
Oracle, a multinational software company, lobbied on a number of health IT issues in 2016, including those related to health information exchanges, transparency, medical privacy and HIT standards. It also lobbied on the 21st Century Cures Act, Precision Medicine Initiative and the Cancer Moonshot.



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