Money in Politics

Legislating Under the Influence

Health Care Report, June 2009

The crisis in health care is undisputed. Costs continue to skyrocket and tens of millions of Americans are without coverage, leading President Barack Obama to make comprehensive reform a cornerstone of his campaign message and his domestic agenda.

Yet citizens worry that Congress will fail to adequately reform our health care system. More precisely, Americans know that the campaign cash and lobbying by wealthy, powerful industries on Capitol Hill could scuttle real reform, as it has in the past.

A recent poll found that 60 percent of voters believe Congress puts the interests of campaign contributors over constituents, and 79 percent are worried that dependence on large campaign contributions will prevent Congress from tackling the important issues facing America today.

A look at the numbers shows that citizens are right to worry. Major health care interests have spent $1.4 million per day this year lobbying Congress, so you can bet the legislative battle will not simply rest on the merits of each side’s argument. Health care-related industries wield tremendous influence in Washington and have sustained an expensive, high-intensity campaign to protect their own interests.

A new Common Cause health care report, "Legislating Under the Influence," shows how the health care industry has spent billions on campaign contributions and lobbying over the past decade to influence Congress, according to data from the Center for Responsive Politics. The lion's share of that spending has been strategically targeted at leadership, committees with power over their health agenda, and members of the majority party, and has escalated steadily throughout the period. The numbers highlight the tension in our pay-to-play campaign finance system that forces lawmakers to choose between the often-competing interests of their major campaign contributors and the public.

Key findings include:

Health industries – including health insurance, pharmaceuticals and health products, hospitals and HMOs, and health professionals – have contributed over $372 million in campaign contributions to members of Congress since 2000.

Political spending by the health industries has increased 73 percent since 2000. Health interests contributed about $94 million to candidates for Congress in the 2008 election cycle, up from about $54 million in the 2000 cycle.

Members serving on committees and subcommittees with jurisdiction over health care reform in the House and Senate received the lion's share of health industries' largesse. Committee members raised $178 million from the industries this decade – roughly half of the industries' contributions to the entire Congress. Since 2000, the House members sitting on health committees have raised twice as much money from the health industry per election cycle as non-committee members (an average of 171,000 compared to 87,000), and the average House member on a key health subcommittee hauled in three times as much per cycle ($269,000). Senators with plum committee posts also enjoy sizable fundraising advantages.

The industries engage in "switch-hitting" – shifting campaign contributions between Democrats and Republicans to win access with the party in power. In 2000, with Republicans controlling the House and a closely-divided Senate, Republicans on health-related committees received more than double what Democrats received (68 percent to 32 percent) from the health industries. In 2008, with Democrats controlling both the House and Senate, over 61 percent of the industries' contributions to committee members went to the majority Democrats and just 39 percent went to Republicans.

The major health interests have spent an average of $1.4 million per day to lobby Congress so far this year and are on track to spend more than half a billion dollars by the end 2009. That comes out to about $2,600 per day per member of the House and Senate. The pharmaceutical lobby alone spent $733,000 per day in the first quarter of 2009. Since 2000, the industries have spent over $3 billion on lobbying, with the total increasing every year and rising more than 142 percent over the course of the decade. In each of the past four years health interests have been the number-one lobbying force in Washington, measured in expenditures, and have averaged over $1 million per day.

To download the full report, go to

Updated Appendix: Tables showing the historical campaign contributions from health care industry, including health insurance companies, from 2000-2008 election cycles (1999-2008) to the members who sit on the committees in the House and Senate with jurisdiction over health care policy. (Download)

Addendum: Tables showing campaign contribution so far in 2009 to the members who currently sit on the committees in the House and Senate with jurisdiction over health care policy and are now in the process of drafting legislation to overhaul the entire health care system. (Download)