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A health care lobbying boom

Presented by Driving the Day MONEY TALKS — U.S. health care companies are pouring unprecedented sums of money into lobbying efforts as they vie for influence with the Trump administration and the GOP congressional majority, POLITICO's Amanda Chu reports. Newly released lobbying disclosure reports show the Pharmaceutical Research and Manufacturers of America, the trade group for brand-name drugmakers, spent $7.58 million on lobbying in the second quarter, the highest amount it's spent for the period, according to a POLITICO analysis. Leading members Bristol-Myers Squibb and Merck recorded their highest spending for any quarter. Insurance companies have also boosted spending. AHIP, the industry group, spent $4.05 million in the second quarter, its highest for the period on record. The American Hospital Association, meanwhile, reported $6.15 million, its second-highest for the period. The record spending comes as the Trump administration vies to overhaul the U.S. health care sector, posing the biggest threat to industry profits in years and signaling a broader shift in the relationship between corporate America and the traditionally pro-business Republican Party. President Donald Trump has approved nearly a $1 trillion cut in federal funding for Medicaid, threatened to impose tariffs on pharmaceuticals and demanded that drugmakers lower their prices. Health Secretary Robert F. Kennedy Jr. has repeatedly questioned the safety of vaccines, rolling back Covid-19 guidance for healthy children and healthy pregnant women, and overhauling the CDC's advisory panel on vaccines. 'Historically, the business community has seen total Republican control of D.C. as a period of great opportunity for their legislative priorities,' said Jeffrey Kimbell, president of Kimbell & Associates, which represents large pharmaceutical companies. 'While that is still the case, the current administration and some Republicans in Congress also require some industries to continue their defensive posture.' Lobbying firms with ties to key lawmakers and administration officials are reaping the benefits as companies and trade groups seek inroads with Trump and Republicans in Congress. Tarplin, Downs & Young and Todd Strategy Group ranked among the top firms representing pharmaceutical companies in Washington in the second quarter, according to a POLITICO analysis of disclosures. Each firm has strong GOP connections. Linda Tarplin was HHS's liaison to Congress when George H.W. Bush was president. Dan Todd worked for then-Utah GOP Sen. Orrin Hatch on the Finance Committee. WELCOME TO WEDNESDAY PULSE. This is your friendly CMS reporter, Robert King, filling in for your regular hosts Sophie and Kelly today. I am still picking through thousands of pages of payment rules released last week. If you have any thoughts, or know something I missed, please share at rking@ or khooper@ and sgardner@ and follow along @rking_19, @kelhoops and @sophie_gardnerj. In Congress LAWMAKERS TEE OFF ON MA — After a bruising fight over Medicaid cuts in President Donald Trump's megabill, Republicans and Democrats joined together on a health issue they both agree on: reining in privately run Medicare Advantage plans. Members of the House Ways and Means Committee's oversight and health panels discussed during a hearing Tuesday the need for reforms to the popular program that enables older Americans to receive benefits like hearing and vision care outside of traditional Medicare. Lawmakers blasted the plans for high rates of care denials and overspending. 'We know of concerns about MA plans inflating a patient's level of sickness resulting in higher reimbursements for the plan at taxpayer expense,' said Chair Jason Smith (R-Mo.). 'An estimated $40 billion in 2025 alone.' Rep. Lloyd Doggett(D-Texas), ranking member of the panel's Health Subcommittee, said the plans have been overspending traditional Medicare despite the intention to do the opposite. 'Medicare Advantage was sold as a program to save taxpayer dollars and improve quality of care, but I have found that it is largely disadvantages,' he said. Why it matters: The hearing was a spark of bipartisan comity after months of acrimony surrounding the One Big Beautiful Bill Act, which Congress passed earlier this month. The legislation included more than $1 trillion in cuts to health spending over the next decade, with most cuts coming from Medicaid. Medicare Advantage reforms have long engendered bipartisan support — but not enough to get them through Congress. Lawmakers are making another run. Doggett and Rep. Greg Murphy (R-N.C.), chair of the GOP Doctors Caucus, introduced legislation Monday that would mandate MA contract rates to providers. Some MA plans and hospitals have clashed nationwide over rates, with hospitals complaining about high levels of prior authorization requests. The Prompt and Fair Pay Act would mandate MA plans to reimburse all covered items and services for at least what Medicare pays, noting that some plans pay providers below that line. AROUND THE AGENCIES THEORY LIVES ON — In a new report on Covid-19's origins, Dr. Robert Kadlec, who was a top health official in the first Trump administration, says Chinese military researchers might have played a role in developing the virus, POLITICO's Carmen Paun reports Kadlec, who led the Covid-19 vaccine development program known as Operation Warp Speed, would be well-positioned to push for greater scrutiny of China if the Senate confirms him as assistant secretary of defense for nuclear, chemical and biological defense programs. The White House and congressional Republicans have embraced the hypothesis that a lab leak, and not a natural spillover of the virus from animals to humans, triggered the pandemic that killed millions of people globally. Zooming in: The report, published Monday by the Scowcroft Institute of International Affairs at Texas A&M University's Bush School of Government and Public Service, adds to the assertion by three U.S. intelligence agencies that the pandemic started as an accidental lab leak in Wuhan, China, where the first Covid cases were reported in late 2019. The agencies haven't alleged a Chinese military role. But, but, but: There's still no scientific consensus on how the pandemic began, with many virologists continuing to argue that the virus wasn't engineered and the global outbreak had a natural origin. A spokesperson for the Chinese embassy in Washington pointed to a 2021 report by the Chinese government and World Health Organization-appointed experts that concluded that a lab leak origin was 'extremely unlikely.' The spokesperson called that conclusion 'the authoritative scientific conclusion drawn by the China-WHO joint expert group based on field visits to relevant laboratories in Wuhan and in-depth exchanges with relevant scientific researchers.' While Kadlec's report states that a natural spillover from animals to humans remains a possibility, he argues that's doubtful because the virus contains features from different coronavirus strains that don't exist in nature in close proximity. That makes it unlikely that the virus recombination would have happened naturally, he said. Kadlec's concerns about Covid's lingering effects on the brain conflict with Health Secretary Robert F. Kennedy Jr.'s push to deemphasize Covid vaccination. Given the potential for even mild Covid infections triggering long Covid in children and adults, Kadlec's report calls for efforts to screen and test children. The Trump administration suspended a program offering free tests in March. Public Safety ORGAN OVERSIGHT FAILURES — House lawmakers grilled leaders in the nation's organ procurement and donation system Tuesday after a federal report revealed that an organ procurement organization had operated on patients showing signs of life, POLITICO's Amanda Friedman reports. The House Energy and Commerce Oversight and Investigations Subcommittee's hearing followed a Health Resources and Services Administration investigation into the Kentucky-based OPO, Network for Hope. A report released in March found that the OPO had harvested organs from more than two dozen patients who might not have been definitively deceased, failed to reassess brain function and kept poor records of what happened. Subcommittee Chair John Joyce (R-Pa.) said the findings 'fractured the physician-patient relationship' and demanded accountability from the OPO and the United Network for Organ Sharing, the nonprofit that oversees the national transplant system. Dr. Raymond Lynch, who leads HRSA's Organ Transplant Branch, told lawmakers the issues aren't isolated: 'Unfortunately, it is not limited to [Network for Hope].' Other concerns: Members also raised concerns about systematic racism and whistleblower retaliation. UNOS CEO Maureen McBride faced questions about racial bias lawsuits, while Network for Hope CEO Barry Massa defended his group's procedures but acknowledged communication failures. What's next: HHS warned the OPO could be decertified on Monday. HRSA gave the group until July 28 to submit an initial remediation plan. Names in the News Vincent Bellomo is now an adviser at the Department of Health and Human Services. He most recently was a special assistant to the Secretary of HHS. WHAT WE'RE READING POLITICO's David Lim reports on the confirmation of Terry Cole to head the Drug Enforcement Administration. POLITICO's Katherine Tully-McManus reports that Sen. Elizabeth Warren (D-Mass.) will vote against the Senate's first batch of funding bills — signaling her party that she won't be cooperative in the fall funding fight. The New York Times's Nina Agrawal and Allison Jiang write about the changing face of lung cancer.