The nation's largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues, according to an analysis of lobbying disclosures and other records.
The tactic is so widespread that three of every four major health-care firms have at least one former insider on their lobbying payrolls, according to The Washington Post's analysis.
Nearly half of the insiders previously worked for the key committees and lawmakers, including Sens. Max Baucus (D-Mont.) and Charles E. Grassley (R-Iowa), debating whether to adopt a public insurance option opposed by major industry groups. At least 10 others have been members of Congress, such as former House majority leaders Richard K. Armey (R-Tex.) and Richard A. Gephardt (D-Mo.), both of whom represent a New Jersey pharmaceutical firm.
The hirings are part of a record-breaking influence campaign by the health-care industry, which is spending more than $1.4 million a day on lobbying in the current fight, according to disclosure records. And even in a city where lobbying is a part of life, the scale of the effort has drawn attention. For example, the Pharmaceutical Research and Manufacturers of America (PhRMA) doubled its spending to nearly $7 million in the first quarter of 2009, followed by Pfizer, with more than $6 million.
The push has reunited many who worked together in government on health-care reform, but are now employed as advocates for pharmaceutical and insurance companies.
A June 10 meeting between aides to Baucus, chairman of the Senate Finance Committee, and health-care lobbyists included two former Baucus chiefs of staff: David Castagnetti, whose clients include PhRMA and America's Health Insurance Plans, and Jeffrey A. Forbes, who represents PhRMA, Amgen, Genentech, Merck and others. Castagnetti did not return a telephone call; Forbes declined to comment.
Also inside the closed committee hearing room that day was Richard Tarplin, a veteran of both the Department of Health and Human Services and the Senate, where he worked for Christopher J. Dodd (D-Conn.), one of the leaders in fashioning reform legislation this year. Tarplin now represents the American Medical Association as head of his own lobbying firm, Tarplin Strategies.
"For people like me who are on the outside and used to be on the inside, this is great, because there is a level of trust in these relationships, and I know the policy rationale that is required," Tarplin said in explaining the benefits of having government experience.
But public interest groups and reform advocates complain that the concentration of former government aides on K Street has distorted the health-care debate, and that it further illustrates the problem posed by the "revolving door" between government and private firms.
"The revolving door offers a short cut to a member of Congress to the highest bidder," said Sheila Krumholz, executive director of the Center for Responsive Politics, which compiled some of the data used in The Post's analysis. "It's a small cost of doing business relative to the profits they can garner."
Aides to Baucus and other lawmakers bristle at any suggestion of special treatment for former staff members. Baucus spokesman Scott Mulhauser said the senator "remains committed to working with a variety of stakeholders" as the Finance Committee attempts to come up with a bill this summer.
"The senator and his staff meet daily with individuals, nonprofits and interests from across the health-care spectrum, and are proud that all interests are treated equally and that no one receives special treatment of any kind," Mulhauser said. "As a result, the Finance Committee has been praised by members of Congress and the media for its uniquely inclusive and transparent health-care reform process."
The Post examined federally required disclosure reports submitted by health-care firms that spent more than $100,000 lobbying in the first quarter of this year. It used current and past filings to identify former lawmakers, congressional staff members and executive branch officials.
The analysis identified more than 350 former government aides, each representing an average of four firms or trade groups. That tally does not include lobbyists who did not report their earlier government experience, such as PhRMA President W.J. "Billy" Tauzin, a former Republican congressman from Louisiana. Federal law does not require providing such detail.
Overall, health-care companies and their representatives spent more than $126 million on lobbying in the first quarter, leading all other industries, according to CRP and Senate data. PhRMA led the pack in spending and employs 49 former government staff members among its 136 lobbyists, according to The Post's analysis. Dozens of other former insiders are employed as lobbyists by Pfizer, Eli Lilly, the AMA and the American Hospital Association, each of which spent at least $3.5 million on lobbying from January through March.
The aim of the lobbying blitz is simple: to minimize the damage to insurers, hospitals and other major sectors while maximizing the potential of up to 46 million uninsured Americans as new customers. Although many firms have vowed to help cut costs, major players such as PhRMA, America's Health Insurance Plans and others remain opposed to the public-insurance option, a key proposal that President Obama has endorsed.
Several major Democratic bills include such a plan, but Baucus's committee -- which is acting as the central broker in the debate -- has not committed to the idea. Instead, the Finance Committee has focused recently on private-insurance cooperatives and other proposals seen as more palatable to the insurance industry and centrist Democrats. More than 50 former employees of the committee or its members lobby on behalf of the health-care industry, records show.
Deploying former government officials is a key strategy for pressing such positions on Capitol Hill, according to industry lobbyists, many of whom discussed the issue on the condition of anonymity. They say that legislative or administration experience helps ensure that policies considered by Congress do not imperil health-care interests, which account for about one-sixth of the U.S. economy.
At the same time, these lobbyists say, a personal connection to lawmakers and their staffs does not guarantee success.
"If anyone thinks hiring a former staffer for Baucus or [Charles] Schumer or Blanche Lincoln is going to get them what they want, they are crazy," said one health-care lobbyist who used to work on the Finance Committee, referring to several key Democratic senators. "If we were being judged on that, a lot of us should be fired."
William K. "Billy" Wynne, a former Baucus health counsel who now works for the Health Policy Source lobbying firm, said that "there's nothing insidious" about medical companies and groups hiring former legislative staff members. He also notes that he is subject to a two-year limit on contacts with Baucus's office.
"The technical processes of the House and Senate are not intuitive or widely known," Wynne said. "Like with any service, people who have experience are going to be valuable to people who don't."
Some trade groups and companies appear to emphasize hiring lobbyists with legislative or executive experience. Wellpoint, one of the world's largest insurance conglomerates, employs 11 lobbyists with government experience and three with none. One of its veterans is Stephen Northrup, who worked for several years for Sen. Mike Enzi (R-Wyo.), including a year as his health policy director on the Senate Health, Education, Labor and Pensions Committee.
"I think the experience on Capitol Hill gives you a better appreciation of the challenges that members and staff face," said Northrup, who began his Washington career as a lobbyist before entering government. "Every institution has its own rhythm. You need to understand when people need information."
The personal and professional ties between lawmakers, their staffs and lobbyists are often complex. Consider the case of Tarplin and his wife, Republican lobbyist Linda Tarplin. The two worked on opposite sides of the Family Medical Leave Act debate in the 1990s, and each has held high-ranking HHS positions -- he for Bill Clinton and she for George H.W. Bush.
Now they run their own health-care lobbying firms, drawing on their connections. Last year, Richard Tarplin's firm reported $650,000 in lobbying income and his wife's firm -- Tarplin, Downs and Young -- reported $3.5 million.
"We have been in situations that are much more combative than this," Linda Tarplin said of the health-care fight. "Both Democrats and Republicans want health-care reform. The rub has always been they tend to get there in different ways."
At least eight former HHS appointees have also crossed over into health-care lobbying, representing more than 25 companies with a stake in the reform legislation. Most were presidential appointees with high-ranking positions, such as the Tarplins.
A few have also cycled back into government. Jack Charles Ebeler, a former Clinton HHS official, left his job as president and chief executive of the Alliance of Community Health Plans a few months ago to become senior adviser for health policy on the House Energy and Commerce Committee.
Financial disclosure statements show that Ebeler received consulting fees over the past two years from UnitedHealth Group, Academy Health, the Medicare Rights Center, the Center for Health Care Strategies and the International Foundation of Employee Benefit Plans. Ebeler declined interview requests by The Post.
One of the most prominent examples of Washington's revolving door is Tauzin, who took the $2.5 million-a-year job as head of PhRMA in 2005 after shepherding a Medicare prescription drug plan through Congress.
Uproar over the appointment led Congress in 2007 to pass a bill barring former members from bringing clients onto the House and Senate floors and from lobbying their friends in members-only gyms. The legislation also forbade direct lobbying contacts with former colleagues for a year in the House and two years in the Senate; efforts to enact a wider ban went nowhere.
Tauzin and other lobbyists rebuff critics, arguing that it is unsurprising that those with experience on Capitol Hill should then draw on that background.
"Is it a distortion of baseball to hire coaches who have played baseball? Is it a distortion of universities to hire from academia?" Tauzin asked rhetorically. "The bottom line is that people work in the fields in which they have experience. Somehow there are people who think that's unusual for politics, but I think it's pretty normal."
Graphics editor Karen Yourish, database editor Sarah Cohen and research editor Alice Crites contributed to this report.