Health Care Trade Groups Leaning Right

Does the medical industrial complex endorse health care’s status quo? Do its major players think a divided and therefore paralyzed Congress will prevent the multiple crises that will hit in full force early next year? Judging by their campaign contributions during the run-up to the mid-term elections, which are now less than two weeks away, the answers are yes and yes.

Every major sector of the industry has reasons to be upset by the actions taken by the Trump regime and the Republican-run Congress over the past 20 months. Hospitals’ and physician practices’ uncompensated care costs are surging as millions of people lose health insurance due to Medicaid’s new work rules and the GOP’s failure to renew Covid-era Obamacare subsidies.

Things are about to get a lot worse. The biggest hits begin next year when the full Medicaid cuts kick in, and millions more people lose coverage.

The sector’s workforce is being hammered by the regime’s anti-immigration policies. An estimated 17 percent of all health care workers are immigrants, with the highest concentrations in critical areas like home health, nursing homes, and hospital support staffs. Out-of-control ICE raids are not just chasing valued workers away; ICE agents’ well-publicized violence has sharply curtailed the overseas pipeline for new recruits.

Physician autonomy is under full-scale assault. The nation’s doctors are suffering from unprecedented levels of burnout and frustration, exacerbated by the insurance industry’s escalating use of prior authorization. Their professional status faces an existential threat from artificial intelligence. This year’s Medicare pay increase lagged behind inflation despite a one-time bump of 2.5 percent, which goes away next year.

Let’s move on to the two areas where, rhetorically at least, there is bipartisan support for curtailing profit-seeking overreach. Government-funded research—the pharmaceutical industry’s seed corn—has been slashed. Innovation has taken flight on an easterly wind to China. On drug pricing, while the Trump regime hasn’t done anything more than what was required under the price negotiations passed during the Biden years, it backs international reference pricing, which would sharply lower Big Pharma’s revenue.

Even the insurance industry—whose biggest fan, Dr. Mehmet Oz, now sits atop the Centers for Medicare and Medicaid Services—is facing tough times. The government gave Medicare Advantage plans just a 5 percent bump for 2027, which was several percentage points below medical inflation. While they are being overpaid to the tune of about $80 billion a year and deserve cuts, insurers responded by raising co-pays and deductibles in next year’s plans, even as they abandoned many markets in what had been their fastest-growing and most profitable segment.

Whither donations?

The nation’s pollsters and pundits are unanimous in predicting Democrats will win control of the House. They increasingly see Trump’s rock-bottom popularity tipping the Senate their way, too. You would think this would be a good year for the health care sector’s major actors to punish those that have harmed their economic interests by refusing to back GOP incumbents, especially given the fact that as many as 260 candidates for House and Senate seats have declared they will not take campaign contributions from corporate political action committees (PACs). That includes most of the Senate seats in swing states that will determine who controls the upper body next year.

Health care’s major players rarely suffer when Democrats are in power, and have been major beneficiaries of each of the party’s insurance expansions (Medicare, Medicaid, the Children’s Health Insurance Program, Obamacare). Some insurers also prospered by taking on management of state Medicaid programs (they cover about three-quarters of beneficiaries in red and blue states alike).

Hospitals and doctors have dodged significant payment reforms—not just single-payer Medicare for All, but more gradualist approaches to reining in costs like single-pricing, budget-based reimbursement, and rigorous antitrust enforcement. The centrist wing of the Democratic Party, like the GOP, is generally protective of the drug industry, whose headquarters and major research facilities are located in blue states.

Regular readers know I’m supportive of dramatic reforms that would move the system toward achieving what former CMS administrator Donald Berwick called the triple aim: A healthier population achieved at a lower cost with a better patient experience. His successors at the Institute for Healthcare Improvement later added workforce well-being and health equity to the mix.

Anything the Democratic Party enacts, should they win Congress this year and the presidency in 2028, will move the system closer to those goals. Everything the GOP and its leader imposed over the past two years moved the system away from those goals. They hobbled Obamacare; eviscerated public health; endorsed anti-vaccine know-nothingism; assaulted Medicaid; and embraced ideological manipulation of the nation’s research enterprise.

Should the GOP retain unchecked power for the next two years, surely all the big players in health care understand that they will face daily threats to their stated public purpose.

Yet, the most recent filings by the political action committees of the American Hospital Association, AHIP (America’s Health Insurance Plans), the Pharmaceutical Research and Manufacturers Association and the American Medical Association reveal the industry is continuing to provide financial support for Republican incumbents. They are still funding the party that’s kicking them in the teeth.

Heath care trade group PACs are backing GOP incumbents for the most part. In Ohio, for instance, the American Hospital Association PAC gave Republican incumbent Jon Husted $10,000 so far this cycle, according to the Federal Election Commission database. They’ve not given a dime to former Sen. Sherrod Brown, the Democratic challenger who lost his seat two years ago, who said he won’t accept corporate PAC money this cycle (although at least one news report says he has).

It’s not like Brown is a flaming radical when it comes to health care. He hasn’t signed onto Medicare for All legislation, calling it impractical.

During his 18 years in the Senate, Brown received near-annual campaign contributions from the AHA. In 2024, he even landed a $2,500 donation from the PhRMA Better Government Committee, despite being a consistent voice for lower drug prices. This cycle, PhRMA gave $4,500 to Husted, the incumbent, and nothing to Brown.

The Maine race pits an aging Sen. Susan Collins against Democrat Troy Dale Jackson, who previously served as majority leader and president of the state Senate. Her vote in committee allowed the One Big Ugly Bill with its Medicaid cuts and refusal to retain Obamacare subsidies to reach the Senate floor (she only voted against the final bill once it became clear the GOP didn’t need her vote to get it passed). So far this election year, that subterfuge earned her a $10,000 contribution from the AHA; $7,500 from AHIP; $5,000 from PhRMA; and $3,500 from the American Medical Association PAC. Her late-arriving challenger, on the other hand, has so far received nothing from any of the major health care PACs. He also has sworn off corporate PAC money.

In Alaska, another potential pickup for Senate Democrats this year, incumbent Republican Dan Sullivan received a $5,000 donation from the AHA. His challenger, Democrat Mary Peltola, who would be the first Native American to serve in the U.S. Senate, has not received anything from the four major health care PACs.

The pattern is even playing out in races without incumbents. In Iowa, the former TV anchor Ashley Hinson has received $5,000 from the AHA and $2,000 from Big Pharma. Her challenger for the seat vacated by Republican Joni Ernst, two-time Paralympic gold medalist Josh Turek, has pledged not to take PAC money and has not received anything from the major health care-related PACs.

In Michigan, Republican Mike Rogers faces a well-funded opponent in Medicare for All advocate and former state public health commissioner Abdul El-Sayed. The Republican has received a $5,500 donation from the AHA. El-Sayed, even if he hadn’t refused to take PAC money, would have received nada from the major health care PACs, each of which is a vociferous opponent of replacing private insurance with a taxpayer-financed public program.

El-Sayed, who has raised $45 million compared to Rogers’ $21 million, according to the latest publicly available filings, is generating significant support from health care workers. That includes nearly a thousand physicians. He’s raised $2.3 million from health care professionals compared to just $23,256 for Rogers, according to the FEC database.

That shouldn’t surprise anyone. When polled, about half of all physicians back a single-payer health care system. And if one throws in a government-run public option for employers who don’t provide insurance and to compete on the Obamacare exchanges, that number rises to around two-thirds of all docs backing a major expansion of the government role in providing health care coverage.

My guess is if Democrats win control of the Senate, you’ll begin to see a lot of health care PAC money flowing to the winners—that is, if the Democrats take it. That’s the way the campaign finance game has always been played in Washington, another system badly in need of change.

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