Sunlight Foundation

Visualizing The Health Care Lobbyist Complex

As Featured on NPR's All Things Considered // Dollar Politics // 07.22.09

Health care reform is a major piece of this year's legislative program. In total, five committees will have held hearings on the issue and marked up a bill to reform the health care system in the United States. One of those committees stands out as the key arbiter on the many sticking points of the proposed legislation, the Senate Finance Committee.

The Finance Committee contains a high volume of lawmakers with close ties to the health and insurance industries through both campaign contributions and personal relationships. The visualizations below highlight these influences by mapping former staffers of Finance Committee members who have since become lobbyists for health and insurance interests and showing the number of contributions given to the committee members from these industries.

We'll keep updating this page as we post more research and visualizations.

  1. 1. The Max Baucus Health Care Lobbyist Complex

    (original blog post is available here)

    Mapping Max Baucus’ Health Care Lobbyist Complex. Click image for full visualization.

    As the chair of the Senate Finance Committee, Sen. Max Baucus is at the center of the congressional effort to craft health care reform legislation, a top priority of President Barack Obama. The Baucus-headed Finance Committee has been singled out by advocates and news organizations as the toughest obstacle for the President’s health care priorities. Containing more moderate and conservative members may not be the only reason. The committee is packed with lawmakers who have close ties to the health care and insurance industries, receiving large campaign contributions as their former staffers turn around to lobby for the very interests whose issues — in this case health care — they previously worked on. Baucus, as chair, stands out in particular.

    Lobbying disclosure filings for the first quarter of 2009 reveal that five of Baucus’ former staffers currently work for a total of twenty-seven different organizations that are either in the health care or insurance sector or have a noted interest in the outcome. The organizations represented include some of the top lobbying organizations in the health sector: Pharmaceutical Manufacturers and Researchers of America (PhRMA), America’s Health Insurance Plans (AHIP), Amgen, and GE Health Care.

    The former staffers turned lobbyists include two former chiefs of staff, David Castagnetti and Jeff Forbes, and one former legislative assistant, Scott Olsen. Other former staffers working with health care portfolios include Angela Hoffman and Roger Blauwet.

    The overall health and insurance sectors haven’t just been kind to Baucus’ staffers, but they’ve also aided his campaigns handsomely over the years, especially in his barely contested 2008 reelection campaign. In 2008, Baucus received $1,148,775 from the health sector and $285,850 from the insurance sector. For his career he has received $2,797,381 from the health sector and $1,170,313 from the insurance sector.

    The accompanying visualization shows the connections from Baucus to his staffers-turned-lobbyists to their health care sector clients, which, in some cases, overlap. Most of the organizations are directly involved in the health care or insurance industries. A couple, the Business Roundtable and Wal-Mart, may seem to fall outside of the realm of health care, however both are playing key roles. The Business Roundatble is lobbying heavily on the issue and Wal-Mart is a big seller of prescription medications and has a large stake in the outcome.

    All data comes from OpenSecrets.org.

  2. 2. Senate Finance Committee Health Care Influence Cluster: The Democrats

    (original blog post is available here)

    Last week, I took a look at the circle of former staffers turned health care lobbyists that surround Senate Finance Committee Chair Max Baucus. The Senate Finance Committee is one of the two central committees in the Senate charged with formulating health care reform legislation. Knowing the connections to the health care lobby of all committee members provides us with a glimpse into whom may have access to shape the forthcoming legislation. In continuing with mapping Baucus’ connections, below you’ll find a map of all the committee Democrats and their connections, through former staffers turned health care lobbyists, to various health care lobbies:

    The map shows only ten of the thirteen committee Democrats, as OpenSecrets.org does not report any staffers turned health care lobbyists for Sens. Jay Rockefeller, Jeff Bingaman or Bill Nelson. These ten Democrats are connected to a total of 20 former staffers turned health care lobbyists. Sen. Baucus leads all of the committee Democrats with five health care lobbyist connections and Sen. Chuck Schumer and Tom Carper both have three connections.

    These 20 staffers represent approximately 91 different organizations, often overlapping in the clients they handle. The overlap usually occurs when the health care lobbyists are employed at the same firm. This can be seen clearly with David Castagnetti, Sen. Baucus’ former chief of staff, and Kelly Bingel, Sen. Blanche Lincoln’s former chief of staff. Both Castagnetti and Bingel work for Mehlmen Vogel Castagnetti Inc. and handle nearly all the same clients.

    The organizations represented by these 20 health care lobbyists include some of the biggest opponents to center piece of President Obama’s health care plan: the public option. These include the American Medical Association, the American Hospital Association, PhRMA, and various pharmaceutical, medical device and insurance companies. The Senate Finance Committee is seen as the biggest obstacle to the public option.

    When it comes to money from the health care and insurance industries, Sen. John Kerry, the 2004 Democratic nominee for president, leads the pack. For senators who have not run for the presidency, which requires raising exhorbitant amounts of money, Sen. Baucus is ahead of other committee Democrats with Sens. Schumer and Kent Conrad following close behind. See the table below:

    Senator 2008 Health Sector Career Health Sector 2008 Insurance Sector Career Insurance Sector
    MAX BAUCUS (D-MT) $1,148,775.00 $2,797,381.00 $285,850.00 $1,170,313.00
    JOHN D. ROCKEFELLER IV (D-WV) $515,150.00 $1,674,229.00 $107,874.00 $394,074.00
    KENT CONRAD (D-ND) $117,350.00 $1,331,363.00 $56,650.00 $821,187.00
    JEFF BINGAMAN (D-NM) $14,151.00 $861,841.00 $1,500.00 $160,875.00
    JOHN F. KERRY (D-MA) $289,430.00 $8,145,141.00 $90,250.00 $1,397,367.00
    BLANCHE L. LINCOLN (D-AR) $226,753.00 $1,281,608.00 $49,500.00 $440,033.00
    RON WYDEN (D-OR) $96,925.00 $1,161,488.00 $45,999.00 $229,173.00
    CHARLES E. SCHUMER (D-NY) $10,000.00 $1,402,358.00 $3,000.00 $946,400.00
    DEBBIE STABENOW (D-MI) $239,018.00 $1,188,186.00 $40,800.00 $246,750.00
    MARIA CANTWELL (D-WA) $48,951.00 $573,076.00 $12,300.00 $80,850.00
    BILL NELSON (D-FL) $60,015.00 $1,163,210.00 $22,500.00 $520,016.00
    ROBERT MENENDEZ (D-NJ) $81,650.00 $1,216,476.00 $67,450.00 $458,679.00
    THOMAS CARPER (D-DE) $15,450.00 $452,000.00 $28,700.00 $447,984.00

    For Senate Finance Committee Democrats, the connections to the health care industry are wide and deep. Campaign contributions are high and staffers easily jump ship to lobby their former bosses. The impact of these influence measures are sure to be felt in the debate over the form of health care reform.

    Stay tuned later this week as we look at the other side of the committee: the Republicans.

    Technical Notes: The “Gmap” interface is courtesy of Google and the UCL Google Maps Image Cutter. The graph/map was generated using the Graph library of Nodebox.

  3. 3. Senate Finance Committee Health Care Influence Cluster: The Republicans

    (original blog post is available here)

    Over the past few weeks, our designer Kerry and I have visualized the health care lobbyist connections of Senate Finance Committee members. The Senate Finance Committee has emerged as the key congressional committee in the debate over President Obama’s promised health care reform legislation. The committee is also packed with members with tight ties to the health care industry. By revealing the former staffers of Finance Committee members who have become lobbyists for the health care industry, we can show how close these connections are. Previously, visualizations were created highlighting Senate Finance Committee Chair Max Baucus and the Democrats on the committee. Below is a visualization of the Senate Finance Committee Republicans and their connections to the health care industry through former staffers turned lobbyists. (view fullscreen)


    (available as a large PNG file, as well)

    The map shows nine out of ten committee Republicans with former staffers turned health care lobbyists. OpenSecrets.org does not report any staffers turned health care lobbyists for Sen. John Cornyn. These nine Republicans are connected to 22 different health care lobbyists.

    Both Sens. Charles Grassley and Orrin Hatch have four connections to former staffers. Both senators are in powerful positions on the committee, especially as it pertains to health care legislation. Grassley is the current ranking member on the full committee and Hatch is the ranking member on the Health subcommittee. Both are also top recipients of money from the health and insurance industries. Over his career, Grassley received $1,876,479 from the health industry and $858,224 from the insurance industry. Hatch, meanwhile, pulled in $2,311,744 from the health industry and $659,307 from the insurance industry over his career.

    These 22 lobbyists represent over 100 different health care organizations. Unlike with some of the lobbyists connected to committee Democrats, there is little overlap in clients. It appears that most of these staffers turned lobbyists have their own unique portfolios.

    As with former staffers on the Democratic side, these lobbyists represent some of the top health care organizations lobbying in Washington. Eli Lilly, Pfizer, PhRMA, Blue Cross Blue Shield, and Merck are all represented.

    The money from the health and insurance industries into Republican committee member campaigns is relatively high. The insurance industry is the top contributor to Sen. Grassley’s campaigns over his career. Pharmaceutical companies are the top contributors to Sen. Hatch’s campaigns. In fact, every Republican committee member has a health or insurance industry as their one or more of their top five career contributors.

    Campaign Contributions for Republican Members of the Senate Finance Committee


    Senator 2008 Health Sector Career Health Sector 2008 Insurance Sector Career Insurance Sector
    CHUCK GRASSLEY (IA) $334,237.00 $1,876,479.00 $72,200.00 $858,224.00
    ORRIN G. HATCH (UT) $122,300.00 $2,311,744.00 $24,880.00 $659,307.00
    OLYMPIA J. SNOWE (ME) $6,000.00 $744,640.00 $5,000.00 $408,490.00
    JON KYL (AZ) $68,550.00 $1,971,968.00 $2,000.00 $533,044.00
    JIM BUNNING (KY) $40,450.00 $1,045,687.00 $45,100.00 $769,016.00
    MIKE CRAPO (ID) $92,000.00 $549,192.00 $63,750.00 $360,932.00
    PAT ROBERTS (KS) $657,749.00 $903,337.00 $157,900.00 $296,342.00
    JOHN ENSIGN (NV) $16,550.00 $1,795,899.00 $19,150.00 $580,690.00
    MIKE ENZI (WY) $287,549.00 $612,715.00 $84,250.00 $240,953.00
    JOHN CORNYN (TX) $950,669.00 $1,994,353.00 $289,069.00 $568,253.00

  4. 4. Key Democrat in Health Care Talks Receives Large Health Industry Contributions in 2009

    (original blog post is available here)

    As the summer of the Democrats’ discontent winds to a close, the head count for health care reform in the Senate begins in earnest. One of the key Democratic senators on the fence is Sen. Blanche Lincoln, a member of the Senate Finance Committee and one of the most vulnerable Democrats in the 2010 election. Lincoln jumped into the news today with a quote to a reporter stating her opposition to a public option plan in a health care reform bill. “I would not support a solely government-funded public option. We can’t afford that,” Lincoln said. The senior Arkansas senator is also the 2nd highest recipient of campaign contributions from the health industry among senators this year.

    According to the Center for Responsive Politics, Lincoln has received $325,350 in contributions from the health industry, as of June 30. The large amount in contributions underlies a constantly shifting position by the senator on health care reform.


    One of Lincoln’s biggest contributors this cycle is the insurance giant Blue Cross Blue Shield. The company’s political action committee and employees have combined to give the senator $29,500 this year alone. Blue Cross Blue Shield and their parent company Wellpoint are vocal opponents of the inclusion of a public option plan in any health care reform bill. Blue Cross Blue Shield is the dominant insurer in Arkansas holding a 75 percent market share.

    Blue Cross Blue Shield does not need to only rely on campaign contributions to reach Sen. Lincoln, as they retain Lincoln’s former top health care policy adviser as a lobbyist. Elizabeth Barnett worked for Lincoln from 2000 to 2007 before leaving to become the top Democratic lobbyist for Blue Cross Blue Shield. Earlier this year, Barnett left Blue Cross to work for Avenue Solutions, where she retains Blue Cross Blue Shield as a client. Avenue Solutions’ profile of Barnett notes that she “had primary responsibility for representing [Blue Cross Blue Shield] and its 39 member plans before the Senate Finance Committee, Senate Democratic Leadership, and other key Senate committees and offices.” Barnett also represents other health industry organizations including UnitedHealth Group, Aetna, Bravo Health, Healthcare Leadership Council, Medco and the National Health Policy Group.

    Barnett is not the only former Lincoln staffer working as a lobbyist for the health industry. Lincoln’s former chief of staff Kelly Bingel is a lobbyist specializing in health care at Mehlman Vogel Castagnetti Inc, the lobbying firm of Sen. Max Baucus’ former chief of staff David Castagnetti. Bingel represents a who’s who of the health care industry including America’s Health Insurance Plans (AHIP) and Pharmaceutical Researchers & Manufacturers of America (PhRMA). AHIP and PhRMA have been largely supportive of health care reform this year. PhRMA, in particular, has supported the current legislation with positive advertising after receiving concessions from the White House and the Senate Finance Committee. Bingel also represents the Business Roundtable, a group that has voiced opposition to health care reform.

    Throughout this year, Lincoln has benefited from countless fundraisers thrown by lobbyists. The Party Time database lists one fundraiser thrown by health care lobbyists for Lincoln. On July 24, Ernst & Young feted Lincoln with a fundraiser hosted by health care lobbyists Nick Giordano (formerly of Sen. Baucus’ staff), Dick Meltzer (since moved on to Speaker Pelosi’s staff), LaBrenda Garrett-Nelson, Holly Bode, Francis Grab, Dave Koshgarian and Jeff Petrich. Contributions from this fundraiser will not be publicly available until the third quarter finance reports are filed.