Lobbying by many health insurance and health services companies has understandably declined since President Obama signed the Affordable Care Act in 2010.
Should we expect K Street’s floodgates to open with the Supreme Court’s decision upholding the act’s constitutionality?
Almost certainly, particularly coming in the midst of the presidential election.
An early signal is in how many companies and organizations have hired new lobby firms.
Although some clients have undoubtedly held back, waiting for the court ruling, at least 13 of the top lobbying organizations have signed contracts with new lobby shops in the past year.
They’ve chosen some of Washington’s major players:
- DLA Piper has signed on with the Blue Cross and Blue Shield Association and MedCo Health Solutions. Blue Cross subsidiaries have also signed with Mehlman Vogel and ML Strategies.
- Mercury/Clark & Weinstock is now representing the Federation of American Hospitals.
- Ogilvy Government Relations registered this month as a lobby shop for Assurant, Inc.
- Alston & Bird is representing Medical Mutual of Ohio and the National Association of Children’s Hospitals.
- Bryan Cave registered in April as lobbyists for Centene Corporation.
- Fierce, Isakowitz & Blalock is representing Kindred Healthcare.
- C2 Group signed with America’s Health Insurance Plans. Partner Scott Styles is a former senior vice president with AHIP.
Even before the expected surge, the health care lobby is huge.
According to data compiled by the Center for Responsive Politics, the insurance industry spent almost $9.8 million last year on lobbying activities. Hospitals and nursing homes spent $20.5 million. Health services and HMOs spent $18.3 million.
Below is a list of top lobby clients (excluding pharmaceuticals and professional associations). Figures are sorted by total expenditures 2009-2012.
| Lobby client | 2012 1Q | 2009 | Increase 2009-2011 |
| Blue Cross/Blue Shield | $5,701,832 | $23,646,439 | -8.7% |
| American Hospital Assn. | $4,365,200 | $18,347,176 | 11.6% |
| America’s Health Insurance Plans | $2,450,000 | $8,850,000 | 10.3% |
| Metlife Inc. | $1,570,000 | $6,160,000 | 4.9% |
| Fresenius Medical Care | $1,087,000 | $3,774,640 | 21.2% |
| Aetna Inc. | $1,248,884 | $2,824,955 | 38.4% |
| UnitedHealth Group | $790,000 | $4,860,000 | -39.5% |
| DaVita Inc. | $765,000 | $2,870,000 | 9.1% |
| Alliance for Quality Nursing Home Care | $770,000 | $3,002,605 | 8.2% |
| Medco Health Solutions | $1,050,000 | $3,547,000 | -18.4% |
| Federation of American Hospitals | $590,000 | $3,870,000 | -38.0% |
| Kindred Healthcare | $620,000 | $2,450,000 | 27.8% |
| Humana Inc. | $200,000 | $3,180,000 | -41.4% |
| Health Net Inc. | $560,000 | $1,940,000 | 11.3% |
| American Health Care Assn. | $478,000 | $1,700,000 | 8.9% |
| Providence Health & Services | $260,000 | $1,887,036 | -34.9% |
| Cigna Corp. | $212,807 | $1,830,000 | -33.3% |
| Express Scripts | $370,000 | $1,290,000 | 31.0% |
| National Assn. of Children’s Hospitals | $481,199 | $1,030,000 | 93.5% |
| HealthSouth Corp | $270,000 | $1,684,327 | -23.1% |
| Universal American Corp. | $117,000 | $2,352,000 | -57.5% |
| UPMC Health System | $80,000 | $1,659,786 | -9.6% |
| Gentiva Health Services | $323,000 | $1,116,244 | 38.9% |
| Greater New York Hospital Assn. | $220,000 | $1,320,000 | 2.3% |
| Assurant | $150,000 | $1,724,000 | -49.2% |
Sources, First Street, Center for Responsive Politics, Senate Office of Public Records, U.S. News, Fortune
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