Part of the Series
Fighting for Our Lives: The Movement for Medicare for All
The private health care industry is hard at work currying favor with key Democrats, especially in the House of Representatives. And with good reason: Its members are increasingly embracing single-payer health care, or Medicare for All.
This system of health care would cover all Americans using a government-financed, centralized insurance system. It would be more cost-efficient, universal and simple. But it is not good for the for-profit health industry, especially insurance companies, who would face near-extinction under some Medicare proposals.
This had not been a serious threat to the industry for decades. For years, Democrats largely stayed away from Medicare for All. At the peak of Democratic Party control of the House in 2009, there were 255 Democrats in the House, 87 of whom co-sponsored single-payer (H.R.676) legislation. After Democrats lost in the 2010 midterms, only 77 of the remaining members supported single-payer. The number hit a low of 62 sponsors in the 114th Congress.
Since then, however, support for the policy has spiked among House Democrats and the public. This spike was, in part, a result of the energy of the Bernie Sanders campaign and a reaction to the failed GOP health reform bills in 2017. Currently, 123 House Democrats (out of 193) are co-sponsors of H.R.676. A new Medicare for All Caucus has also been formed. Given that Democrats are favored to take control of the House, FiveThirtyEight gives them an 86.4 percent chance of winning. This is where the industry is focusing much of its attention.
“The most important impact of this election on the single-payer movement will really depend on whether Democrats are able to retake the House,” said Benjamin Day, director of Healthcare-NOW, in an interview with Truthout. “If they do, there will be intense pressure [for Democrats] to fully embrace single-payer healthcare and start advancing legislation through Congress.”
There is also record public support. A Reuters/Ipsos poll from August 2018 shows 70 percent of the general public supports Medicare for All, including 85 percent of Democrats and 52 percent of Republicans.
The industry is adjusting to the reality of Medicare for All gaining traction under a Democratic House. Their goal is to keep single-payer from becoming the consensus view among Democrats.
It is also why the industry continues to throw money at the party so they remain friendly, especially if they control Congress. If Democrats are going to control the House, the industry wants to control the Democrats (or at least enough of them to keep the stop single-payer momentum).
The health sector has already spent about $197 million this cycle on contributions — a record for midterm races. Which Democrats are on the receiving end of the industry’s contributions?
Here is a look at 10 members of Congress who make up the health industry’s favorite Democrats. The Democrats on this list were among the top recipients of donations from the health industry this election cycle. Those remaining in Congress will be watched closely to see if they will act on behalf of donors or voters. It is not an exhaustive list; the average House Democrat has received $120,000 this cycle. But these are among the most significant due to factors like political contributions, influence, policy positions and relationships with the health industry.
(All data is from Center for Responsive Politics unless otherwise stated.)
Rep. Frank Pallone Jr. (New Jersey 6th District, 1988-present): $6 million
Pallone likes to talk tough on drug prices but has received more money from pharmaceutical companies than any other Democrat in the House of Representatives. In this cycle, he has already received many times more than the average donation from Big Pharma to members of Congress ($36,000).
As the ranking member of the powerful Energy and Commerce Committee, Pallone took a big role in drafting the House version of the Affordable Care Act (ACA). Labor organizers and health advocates have pressured him, but he has chosen not to co-sponsor single-payer legislation. He has $6 million in career donations from the health sector, the most of anyone on this list.
Pharma
2018 Cycle: $251,000
Career Contributions: $1.3 million
Insurance
2018 Cycle: $98,000
Career: $369,000
Professional Organizations
2018 Cycle: $384,600
Career: $3,587,066
Largest Donors
2018 Cycle: Blue Cross Blue Shield
Career: American Dental Association, American Medical Association
Rep. Steny Hoyer (Maryland 5th District, 1981-present): $4.7 million
Hoyer, a tenacious fundraiser, is minority whip, the second-ranking Democrat of the House leadership and the third-largest recipient of donations from drug companies. The current Democratic leadership actively opposes policies that two-thirds of their members co-sponsor and 85 percent of their voters want. Given how far the leadership is from the rest of the party on the issue, it is not a surprise that high-ranking officials such as Hoyer — who has $4.7 million in career donations from the health sector — are among the industry’s favorite Democrats.
His current high donor from the industry this cycle is Blue Cross Blue Shield. More telling, perhaps, is the money he received during the ACA debates and implementation. According to the Center for Responsive Politics, Hoyer was a “top recipient” then from: pharmaceutical manufacturing (#1); health services (#2); hospitals/nursing homes (#2); lobbyists (#3); and pharmaceutical/health products (#4). Hoyer was caught on tape trying to prevent a pro-single-payer candidate from running for Congress in the 2018 primary against the party’s preferred candidates.
Pharma
2018 Cycle: $205,000
Career Contributions: $1 million
Insurance
2018 Cycle: $167,000
Career: $644,000
Professional Organizations
2018 Cycle: $394,000
Career: $2.1 Million
Largest Donors
2018 Cycle: Blue Cross Blue Shield
Career: American Hospital Association
Rep. Ron Kind (Wisconsin 3rd District, 1995-present): $2.6 million
Kind, who has been serving in Congress for over 20 years, can claim health professionals and pharmaceutical companies as the second- and third-largest industry contributors over his career and in this cycle. Only Wall Street has donated more to his campaign. Just four Democrats have received more money from Big Pharma than he has this cycle (two of them on this list). He ranks among the top recipients among Democrats from health professionals and insurance providers. His name has been floated as a potential successor to Nancy Pelosi if the Democrats get to name a House Speaker as a majority.
When constituents ask him about his relationship with donors, he answers with generic platitudes. In February, at a town hall event, he was asked how he “could be transparent on the issue when three of the top five donors to his last campaign were insurance companies.”
“I’m a fierce independent voice in Washington,” Kind responded.
In fact, Kind is chairman emeritus of the New Democrat Coalition (NDC), a corporate-funded caucus that is deep in the pockets of drug companies, as well as Wall Street. Among the contributors to the NDC’s PAC are the American Hospital Association (AHA), American Health Insurance Plans (AHIP), the American Medical Association, Anthem and AETNA — and that’s just starting with the As.
Pharma
2018 Cycle: $177,000
Career Contributions: $846,000
Insurance
2018 Cycle: $68,000
Career: $294,000
Professional Organizations
2018 Cycle: $255.000
Career: $1.2 million
Largest Donors
2018 Cycle: Blue Cross Blue Shield, United, Humana
Career: Blue Cross Blue Shield, American Hospital Association
Rep. Nancy Pelosi (California 12th District, 1988-present): $2.5 million
Despite running in a safe district, Pelosi still receives large contributions from the industry. Health professionals are her leading donors since she took office in 1989. They account for nearly half of the $2.5 million she has received from the health sector in total.
Due to her safe seat and high-profile position, she is a tenacious fundraiser for the Democratic Congressional Campaign Committee (DCCC), which is also indebted to major stakeholders in the industry. At the time of writing, the DCCC had received more than $3.8 million from health professionals and $1 million from pharmaceutical companies so far in 2018.
Pelosi’s relationship to donors is obviously important given her desire to be speaker of the 115th Congress, should Democrats take over. She has continually insisted the party’s voters are not ready for single-payer despite the fact that it polls better than the Affordable Care Act. She is one of the 36 percent of House Democrats who have not sponsored H.R.676. There are indications she may face a challenge to her speakership.
Pharma
2018 Cycle: $34,000
Career Contributions: $392.000
Insurance
2018 Cycle: $17,000
Career: (Data unavailable)
Professional Organizations
2018 Cycle: $317,000
Career: $1.6 million
Largest Donors
2018 Cycle: Blue Cross Blue Shield
Career: American Hospital Association
Rep. Richard Neal (Massachusetts 1st District, 1988-present): $2.4 million
One might think the Massachusetts Congressional Delegation would be among the most progressive on this issue, given Massachusetts’ liberal citizenry and history as a leader on health reform. In reality, the state’s delegation is quite friendly with the health industry. Six out of nine congressmen from the state do not co-sponsor Medicare for All.
Neal, in particular, has the distinction of receiving more money from pharmaceutical companies so far this election cycle than any other party member and eight times more than the average Democrat in Congress. The industry recognizes the great influence he wields as the ranking member of the Ways and Means Committee. This position puts him at the forefront of any serious health reforms, which is why health care advocates have been pressuring the candidate (to date, unsuccessfully) to co-sponsor single-payer legislation.
Pharma
2018 Cycle: $285,000
Career Contributions: $746,000
Insurance
2018 Cycle: $98,000
Career: $269,000
Professional Organizations
2018 Cycle: 227,000
Career: $945,000
Notable Top Donor(s):
2018 Cycle: Blue Cross Blue Shield, AETNA, American Academy of Dermatology Association
Career: American Hospital Association
Rep. Raul Ruiz (California 36th District, 2013-present): $1.9 million
Ruiz is one of only two doctors who are in Congress and are Democrats. As a result, he has quickly become one of the largest recipients of money from professional associations. They have donated $412,000 to Ruiz this cycle, well more than twice the next highest industry on his list. Only two members of the House have received more money from this sector. He gives ambiguous answers on health care, but when pressed specifically on single-payer on a C-SPAN interview, Ruiz pivoted and just mentioned his support for the “public option,” and never offered a firm plan or opinion.
Ruiz was also one of several who benefited from misleading fundraising appeals by the Congressional Hispanic Caucus which wrongly claimed they were fighting on behalf of Sanders’s Medicare for All bill. Bold PAC, the caucus’s primary PAC, also has a Medicare for All donation page. The caucus, however, does not share a consensus on the issue. Of its 30 voting members, only 15 are co-sponsors of H.R.676.
Half of Ruiz’s top 32 donors are in the health sector, including professional associations. Among his donors are the American Hospital Association, Humana and the American Academy of Family Physicians.
Pharma
2018 Cycle: $80,000
Career Contributions: $196,000
Insurance
2018 Cycle: $68,000
Career: $132,000
Professional Organizations
2018 Cycle: $412,000
Career: $1.4 million
Largest Donors
2018 Cycle: American College of Emergency Physicians, Humana
Career: Emergency Medicine Physicians, Florida Emergency Physicians
Rep. Joseph Crowley (New York 14th District, 1999-present): $1.84 million
Joseph Crowley, who lost in the primary to Alexandria Ocasio-Cortez, will not be in Congress — or on this list — a year from now. This is despite the fact that pharma, hospitals and insurance companies were fond of him and threw hundreds of thousands into his race this year and millions over the course of his career.
While he wasn’t a co-sponsor of Medicare for All for the first seven congressional sessions since it was introduced, Crowley signed on to it in 2017 under pressure from his left. Crowley is one of several Democrats in the House and Senate who either qualified their support, or noted that it is “aspirational,” as Crowley put it.
One way to gauge motive and sincerity is to follow the money. This was a point Ocasio-Cortez emphasized, often comparing her small donor base favorably to his large contributions from health, finance and real estate companies, and the industry lost an ally. This demonstrates that despite the massive resources of the private health industry, these compromised politicians can be defeated by a strong grassroots campaign.
Pharma
2018 Cycle: $159,000
Career: $611,000
Insurance
2018 Cycle: $67,000
Career: n/a
Professional Organizations
2018 Cycle: $139,000
Career: $611,000
Largest Donors
2018 Cycle: Pfizer, AETNA
Career: Pfizer Inc.
Rep. Linda Sánchez (California 38th District, 2003-present): $1.2 million
Linda Sánchez’s top donor this cycle — and in her career — is pharma. In April 2017, constituents pressured her on single-payer at a town hall meeting, since she had not supported the Medicare for All bill in the House. This kind of pressure has been a phenomenon at town halls for industry-friendly Democrats. The questions would not let up as she tried to side-step the issue many times.
Seven days later, Sánchez co-sponsored the bill — a promising sign, but it does raise issues about the sincerity of her support, especially since she keeps getting industry money. She doesn’t mention her support for the bill in her congressional website health care page or on her campaign’s website. She is hoping to take over Crowley’s leadership position, chair of the House Democratic Caucus, which would make her the third-ranking Democrat in the House along with a coveted spot on the Democratic Policy and Steering Committee. Sánchez called for Pelosi to step down from the leadership to allow younger leaders to take over.
It will be extremely interesting to see if her support for Medicare for All turns out to have been a political maneuver. If elected, she will have a chance to prove to constituents she is serious by joining the Medicare for All caucus and advocating for the policy in public.
Pharma
2018 Cycle: $187,000
Career Contributions: $477,000
Insurance
2018 Cycle: $72,000
Career: $159,000
Professional Organizations
2018 Cycle: $101,000
Career: $417,000
Largest Donors
2018 Cycle: Blue Cross Blue Shield, AETNA
Career: TwinMed, American Association of Anesthesiologists
Rep. Kyrsten Sinema (Arizona 9th District, 2011-present): $1.1 million
Sinema earns a spot on the list as the second-largest recipient of money from the health insurance industry (recently surpassed by Beto O’Rourke) among House Democrats this election cycle. Sinema, a member of the conservative Blue Dog Coalition, is now running for a Senate seat. She is down 2 points from her Republican opponent. She votes with Trump 60 percent of the time, according to FiveThirtyEight.
“I do not support Medicare for All. I am really focused on the solutions that are realistic, are pragmatic and can get done in our current situation,” she said on Twitter in August.
Pharma
2018 Cycle: $153,000
Career Contributions: $260,000
Insurance
2018 Cycle: $103,000
Career: n/a
Professional Organizations
2018 Cycle: $309,000
Career: $559,000
Largest Donors
2018 Cycle: Blue Cross Blue Shield, UnitedHealth
Career: Blue Cross Blue Shield
Rep. Joseph Kennedy III (Massachusetts 4th District, 2013 – present): $1.1 million
Kennedy is fairly new to Congress. Yet, in less than three full terms he has quickly become an industry favorite and a potential future House Speaker. Kennedy has helped give the drug industry a “pass,” as Lee Fang reported, in opioid-related legislation. At the same time, he was receiving contributions from major stakeholders like Cardinal Health, which has paid millions in settlements on drug cases. As of February, the company was facing 350 lawsuits. Cardinal Health has given Kennedy more than $15,000 this cycle.
The congressman also faced scrutiny over owning stock from the company that patented the controversially priced $1,000-a-day hepatitis C pill and his bizarre opposition to marijuana, a position he shares with Big Pharma. One egregious explanation for his opposition to legalization was that it makes it harder for police and prosecutors to lock people up.
Kennedy, a co-regional chair for the DCCC, has said he supports Medicare for All “in theory,” but he does not sponsor any universal health care legislation. Single-payer groups have been pressuring him hard to change his position.
Pharma
2018 Cycle: $142,000
Career Contributions: $392,000
Insurance
2018 Cycle: $89,000
Career: $162,000
Professional Organizations
2018 Cycle: $160,000
Career: $313,000
Largest Donors
2018 Cycle: Cardinal Health
Career: Partners HealthCare
As the movement for Medicare for All has greatly increased support for the policy in the House in recent years, advocates should recognize that the industry still has its hooks into some of the powerful Democrats in the country. This includes much of the leadership and those holding key committee spots. Studies show a correlation between donor support and sponsorship of single-payer legislation.
If a Medicare for All system is to become a reality, Americans will need to remove health industry money from politics or remove politicians who take this money from office.
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