Health Care Giants Pour Millions Into D.C. Lobbying
by Jinghong Chen
Major players in the health care industry are boosting their lobbying efforts in the first quarter of 2026, with heavy investment in Medicare Advantage-related policies, according to Payer Perspective’s analysis of federal lobbying disclosures.
The disclosures came after CMS announced a higher-than-expected increase in payments to private insurers in MA plans for 2027, at 2.48%, up from the 0.09% increase proposed in its January Advance Notice.
Since the release of the Advance Notice in January, MA advocacy groups have ramped up pressure on regulators, contributing to a surge in lobbying activity in Washington, D.C.
The Better Medicare Alliance, a nonprofit aligned with insurers and providers, spent $680,000 in the first quarter of 2026 — a 33% increase compared with the same period last year. In total, it reported more than $2.18 million in lobbying expenditures in 2025 and hired nine lobbyists, seven of whom previously held government roles, according to data compiled by OpenSecrets and U.S. Congress Lobbying Disclosure Act reports.
The insurer-backed group hosted an executive policy summit on March 3 featuring CMS Director of Medicare and Deputy Administrator Chris Klomp, along with CMS Deputy Administrator and Chief Policy and Regulatory Officer John Brooks.
AHIP, which represents health insurers, reported $5.32 million in lobbying spending in the first quarter of 2026, a 10% increase from the same quarter last year. It spent more than $17.23 million in 2025, up from $11.77 million in 2024. Of its 59 lobbyists, 34 previously held government positions.
Meanwhile, major health plans also boosted their lobbying expenditures amid heightened regulatory scrutiny and policy pressures from the Trump administration, which moved to let enhanced subsidies for Affordable Care Act marketplace plans expire and finalized significant cuts to Medicaid funding.
On Jan. 22, 2026, CEOs from the nation’s five major commercial health insurers — UnitedHealth Group, CVS Health, The Cigna Group, Elevance Health, Inc. and Ascendiun — testified before U.S. House committees, where lawmakers pressed them on affordability, prior authorization and market consolidation.
UnitedHealth Group, the country’s largest private and MA insurer, spent $12.54 million on lobbying in 2025, nearly doubling its 2024 total of $7.52 million. The third- and fourth-largest MA insurers — CVS Health, the parent company of Aetna, and Elevance Health — followed suit, reporting modest increases in their respective lobbying budgets in 2025.
The second-largest MA insurer, Humana Inc., slightly increased its lobbying spending in the first quarter of 2026, reporting more than $2.5 million.
The pharmaceutical sector is matching the insurance industry’s intensity. The Pharmaceutical Research and Manufacturers of America (PhRMA) reported a staggering $12.2 million in lobbying expenditures for the first quarter of 2026 — its second-highest quarterly total on record. The trade association lobbied aggressively on a wide range of issues, including the One Big Beautiful Bill Act, the 340B program and the SECURE Rx Act of 2026.
Individual pharmaceutical manufacturers also ramped up lobbying spending. Eli Lilly, Gilead Sciences, Roche Holding, Merck & Co. and Regeneron Pharmaceuticals each reported their highest quarterly lobbying expenditures on record in the first quarter of 2026.
