This spring, Tenet Healthcare spent $100,000 to rent Brownstein Hyatt Farber Schreck, a longstanding Washington, D.C., lobbying agency, for the primary time. The massive for-profit hospital system stood to lose hundreds of thousands of throughout the pandemic, as elective surgical procedures have been cancelled in a number of states. Because it employed the agency, Tenet and its subsidiaries have been busy making use of for federal through the CARES Act.
Over the subsequent few months, Tenet obtained greater than $1.four billion in CARES Act grants and loans.
It’s unclear how a lot Brownstein Hyatt helped sway the federal government to award that cash. “It is laborious to quantify how a lot of an impact [lobbying] has,” stated Dan Auble, a senior researcher with the Center for Responsive Politics (CRP), a non-profit that tracks the affect of cash on politics.
What is obvious is that the agency’s healthcare enterprise has surged this yr because the federal authorities doled out hundreds of thousands of to massive healthcare entities, and a few of Brownstein Hyatt’s most distinguished lobbyists have private connections to the Trump administration.
Tenet is one in all a number of massive healthcare firms that obtained enormous sums of CARES Act cash whereas working with Brownstein Hyatt — some, like Tenet, for the primary time. The Cleveland Clinic and its subsidiaries took in $964.1 million, LifePoint Health obtained $485.6 million, and Marshfield Clinic obtained $102.four million. AbbVie took in $38.eight million, Walgreens $35.2 million, and Johnson & Johnson $15.1 million. Novartis obtained $14 million and Eli Lilly $7.6 million.
With funding capped by Congress, different entities that Washington insiders say could have been simply as needy obtained nothing. Experts have also questioned why some firms obtained a lot federal help, notably after they report they’re sitting on billions in reserves, and have furloughed and laid off staff. They also wonder how the federal authorities selected which entities to help and the way a lot to assist them.
Brownstein Hyatt gives one lens via which to look at these questions. For this evaluation, MedPage In the present day examined experiences and data from CRP and knowledge from Good Jobs First, which tracks COVID stimulus funding as a part of a broader program on so-called company welfare.
Proving that this highly effective, well-established lobbying agency has particular entry to healthcare policymakers, making it a go-to place for getting CARES Act cash, is elusive. However 2020 has seen the best federal money handout in American historical past, and there isn’t any query the agency has turn into a big healthcare participant whereas using prime Trump marketing campaign donors and former Trump officers.
“That is the way in which the sport is performed and infrequently corporations like Brownstein … that is the place they actually earn their maintain,” stated Meredith McGehee, government director of Issue One, a non-profit centered on following the cash in politics. “Every time the trough is getting crammed with cash, there’s going to be an effort to feed on the trough.”
On two events, Brownstein Hyatt advised MedPage In the present day they might attempt to accommodate an interview request, however as of press time had not made any representatives accessible and didn’t return a number of queries relationship to Aug. 7.
Influencing CARES Act Distributions?
Brownstein Hyatt was based 50 years in the past and has grown right into a diversified lobbying and regulation agency with places of work in Washington, Denver, and 11 other locations throughout the nation. Its roster options each former Democratic and Republican lawmakers and staffers; its most popular issues vary from healthcare to taxes to pure sources.
The agency’s gross income elevated simply over 10% from $186.four million in 2018 to $205.four million final yr, according to The American Lawyer, together with $40.7 million in lobbying income — second nationally. The agency’s authorized workers grew by four.6% and it raised its charges by a 5.2% common.
This yr its first quarter lobbying income exceeded $11 million, TIME reported, up 21% over final yr. Second quarter gross income was up 28% over final yr, and the agency grew to become the highest-earning U.S. federal lobbying agency ($12.9 million) as it signed 26 new clients in all sectors, according to reports. Coronavirus-related work comprised a lot of that surge, an executive told Politico.
“They’ve actually constructed themselves as much as turn into one of many greatest [lobbying] corporations,” Auble stated.
The agency is fashionable among the many top-spending pharmaceutical and healthcare firms. Inside the healthcare sector, Brownstein Hyatt ranked ninth in lobbying receipts for all of final yr ($four million) and already ranks fourth within the first half of this yr ($three.1 million), in response to a CRP evaluation.
Enterprise over the primary half of this yr included $180,000 from LifePoint Well being; $160,000 every from Johnson & Johnson, Walgreens, and Purdue Pharma; and $150,000 from Envision Healthcare, in response to knowledge collected by CRP. Novartis, like Tenet, spent $100,000, and Cleveland Clinic $90,000. Beckman Coulter Diagnostics and Marshfield Clinic spent $70,000 every, and Santa Cruz Healthcare $50,000.
Eli Lilly, which along with the CARES Act handout has additionally obtained federal funding to work on a COVID-19 treatment, spent $110,000 on Brownstein Hyatt.
AbbVie, which is testing its HIV drug as a COVID-19 treatment, spent $120,000. The Federal Reserve has bought $7.four million price of company AbbVie bonds, Public Citizen reported, along with its CARES Act handout.
These quantities are typical of what the businesses paid different healthcare lobbying corporations, in response to an evaluation of CRP knowledge.
“Lobbying is extremely costly for the common particular person, however for a big firm it is a drop within the bucket and the [return on investment] is huge,” stated Robert Maguire, analysis director for Residents for Accountability and Ethics in Washington.
MedPage In the present day contacted the healthcare entities that contracted with Brownstein Hyatt this yr, asking why they employed the agency and the way they might assess its work.
Novartis has labored with Brownstein Hyatt for a number of years, a spokesperson confirmed, declining additional remark. Cleveland Clinic, Eli Lilly, Beckman Coulter, and Purdue Pharma declined remark. Different entities didn’t return queries.
How a lot did the agency assist them safe CARES Act funds?
“The entry they supply is simply enormous,” stated Mike Tanglis, a analysis director for Public Citizen. “There was a good probability these [lobbying] corporations helped firms navigate the system” throughout the early days of the pandemic.
“It is all the time laborious to attract a direct correlation,” Maguire stated. However: “The folks they’re hiring are the individuals who typically know coverage and the coverage course of in some instances higher than the folks passing the legal guidelines themselves. They’re paying for among the greatest experience in Washington, D.C.”
Politico reported that the firm helped persuade Congress to scrap a medical system tax in December on behalf of the Superior Medical Know-how Affiliation (AdvaMed), which contracted with Brownstein Hyatt for $600,000. The affiliation had been combating the tax for at the very least a number of years, McGehee stated.
Medical system producers are among the many greatest spenders in Washington, Auble stated, so he was not shocked to see AdvaMed’s “pet challenge” addressed.
Push Into Healthcare
In early 2019 Brownstein Hyatt trumpeted three hires, noting in a news release it was “happy to announce the growth of its well being care apply.” Managing accomplice Adam Agron stated within the launch: “The mix of their well being care particular authorized data and coverage expertise provides depth to our nationwide well being care apply.”
One of many hires was Emily Felder, a former official on the Facilities for Medicare and Medicaid Providers (CMS). She and Nadeam Elshami — a longtime congressional aide who was Rep. Nancy Pelosi’s chief of workers — have been each employed lately, Auble famous, and are among the many agency’s “principal well being lobbyists.”
Healthcare is now the agency’s third-busiest sector, rising from 10.2% of its lobbying enterprise in 2019 to 13.1% within the first half of this yr, in response to CRP experiences. The agency has 36 lobbying shoppers and 35 lobbyists in healthcare assigned over the primary half of the yr, in response to lobbying disclosure types analyzed by CRP. That doesn’t embody the 21 lobbying shoppers related to medical analysis and scientific labs, 11 with Medicare and Medicaid, and three pharmaceutical lobbying shoppers.
Observers couldn’t say for sure why Brownstein Hyatt has enhanced its well being providers. Chasing CARES Act funds “explains partly why their healthcare apply is booming,” Auble stated, noting that Brownstein Hyatt issued a news release in March promoting a COVID-19 activity power. Many corporations have marketed their experience so as to add shoppers previously, Tanglis famous.
“The larger corporations have been well-positioned to learn from the inflow of recent firms and organizations who very all of the sudden wanted to have a presence in Washington,” Auble added. “They might profit the consumer actually rapidly with out a whole lot of ramp-up.”
Brownstein Hyatt is leveraging an increase in general business spending on lobbying. Three of the highest 10 spenders over the second quarter have been in healthcare, according to Politico: No. three, Pharmaceutical Analysis and Producers of America ($5.four million); No. 6, American Hospital Affiliation (AHA, $four.three million); and No. 7, American Medical Affiliation (AMA, $three.eight million). For the primary half of the yr, PhRMA ($14.6 million), the AHA ($12.5 million), Blue Cross/Blue Defend ($11.three million), and the AMA ($10.eight million) are all within the prime six, in response to CRP, simply forward of Fb and Amazon.
Whereas these numbers are typically up, healthcare spending was comparatively excessive earlier than the pandemic, Tanglis stated. Certainly, prescription drugs/well being merchandise led all industries in 2019 in lobbying spending, in response to CRP, whereas three different well being industries have been additionally within the prime 13.
This yr ,”it is compounded,” Tanglis stated. “Now in some instances there’s much more at stake for them.”
Tanglis expects this pattern to proceed, notably regarding pharmaceutical firms considering capitalizing on COVID-19 vaccine manufacturing.
Brownstein Hyatt boasts a roster filled with lobbyists with connections to the Trump administration. Marc Lampkin, Brownstein Hyatt’s managing director for its Washington workplace and a shareholder, was a Trump 2016 marketing campaign fundraiser who has given the utmost quantity allowed to the Trump marketing campaign each this yr and in 2016, in response to a Public Citizen report.
Brownstein Hyatt coverage director Geoff Burr was as soon as chief of workers for the U.S. Secretary of Transportation; Felder, the agency’s senior coverage advisor, directed CMS’s Workplace of Laws. (A few of them may have violated a Trump executive order.)
These three lobbyists represented 45 shoppers on COVID-19 points over the primary half of the yr, in response to Public Citizen, together with 18 new shoppers. “Eighteen new shoppers is rather a lot for any agency,” Tanglis stated, although he famous that will not be uncommon for a agency as massive as Brownstein Hyatt.
Felder alone this yr has represented AbbVie, Amgen, AdvaMed, LifePoint Well being, Baxter Healthcare, Centene, Cleveland Clinic, Eli Lilly, Johnson & Johnson, Envision Healthcare, Novartis, Tenet, Valley Kids’s Healthcare, Ardent Well being Providers, and Walgreens.
“The revolving door is alive and nicely on this administration,” McGehee stated. “They introduced on extra lobbyists into the administration and spun out lobbyists at a speedy clip.”
Firms hiring lobbyists with connections to administrations will not be new, however “there is definitely some worth in hiring folks related to the Trump administration and it has been very stark this time,” Auble stated.
A broader downside, McGehee stated, is lobbyists leveraging info they gleaned whereas working for the federal government to learn shoppers. “The difficulty will not be that you’re utilizing it, it is that personal curiosity is benefiting from one thing you gained in public service,” she stated.
Brownstein Hyatt has touted its ties to main Trump officers. “Lots of the decision-makers within the companies are former co-workers and colleagues,” it told one client in a letter obtained by the Washington Publish, explaining why the agency was doubling month-to-month charges. The consumer — a North Dakota water conservancy depending on federal companies’ selections — agreed to the brand new charge for the next quarter and now pays the agency triple its December 2017 charge, Tanglis famous. (CRP data present the conservancy’s funds to Brownstein Hyatt elevated from $30,000 in 2017 to $120,000 final yr.)
“It is pretty apparent what the implications of claiming that’s,” Tanglis stated of the letter. “That is additional than [lobbying firms] will typically say.” He added: “Doubling looks like a hefty charge.”
‘Not Hiring Them for No Cause’
Observers additionally famous the affect of Lampkin, a former George W. Bush 2000 marketing campaign chief and strategic advisor to former Home Speaker John Boehner (R-Ohio). Lampkin has lobbied on behalf of shoppers together with AdvaMed, Cleveland Clinic, Eli Lilly, Johnson & Johnson, Novartis, and Purdue Pharma this yr, in response to public data.
Might his profession historical past and most donations to the Trump campaigns have earned his shoppers particular consideration from the administration and the hundreds of thousands in CARES Act ?
“Maxing out is notable whether or not you are a lobbyist or not,” McGehee stated.
“There may be an aide who is aware of who’s giving and who hasn’t, in order that places of work know who’s helped me out by way of marketing campaign finance,” Auble stated. “It is one other avenue of constructing certain your name will get taken and your challenge will get heard.”
Is that how AdvaMed or Eli Lilly, for instance, get what they need?
Observers say it is not far-fetched. Maguire spoke of “a degree of lax oversight that’s distinctive to this administration.” He added: “This administration is especially unconcerned concerning the look of propriety and in some instances impropriety.”
“Having a presence in Washington to make your particular case,” Auble stated, “has some impact on coverage.” Brownstein Hyatt “are definitely making some huge cash and presumably their shoppers should not hiring them for no cause.”
Brownstein Hyatt’s consumer record consists of J2 World, MedPage In the present day‘s mother or father firm, at $60,000 this yr.