Follow The Money
Lobbying, Profits, and the Revolving Door
EP01_03_Follow_the_Money_v3_0 | Updated 2026-04-15
We critique systems and incentives, not individual employees.
Health Sector Lobbying Spend by Year
Source: OpenSecrets.org 2020-2025
1. HEALTH SECTOR LOBBYING -- THE OVERVIEW
The health sector spends more on federal lobbying than any other industry in America. In 2025, pharmaceutical and health product companies alone spent $452 million. Total U.S. lobbying across all industries hit a record $5.08 billion.
The three players in this episode — insurers, drug companies, and their trade groups — all lobby the same committees, hire the same former staffers, and give to the same candidates. The money does not pick a party. It picks a policy.
For how these lobbying dollars connect to the denial mechanisms in the episode, see the Decoder Ring. For the sourced claims behind every number, see the Evidence Locker.
2. FEDERAL LOBBYING -- BY THE NUMBERS
| Entity | 2023 | 2024 | 2025 | PAC (2023-24) |
|---|---|---|---|---|
| UnitedHealth Group | $10,760,000 | $7,520,000 | $9,930,000 | $792,500 |
| The Cigna Group | $10,420,000 | $8,250,000 | TBD | $803,500 |
| AHIP (trade group) | $13,060,000 | $11,770,000 | TBD | $205,580 |
UnitedHealth Group’s PAC raised $3.14 million in the 2023-2024 cycle. Cigna’s PAC raised $2.36 million. UnitedHealth’s total political contributions for the cycle: $4.47 million.
In 2025, UnitedHealth increased its lobbying spend to $9.93 million, up 32% from 2024. The increase coincided with DOJ investigations, federal scrutiny of algorithmic denial practices, and the passage of the One Big Beautiful Bill Act, which included cuts to Medicaid and Medicare.
Source: OpenSecrets — UnitedHealth Group | OpenSecrets — Cigna | OpenSecrets — AHIP
3. THE REVOLVING DOOR
The revolving door between government and the insurance industry is not a metaphor. It is a staffing model.
3.1 AHIP’s Lobbyist Roster
AHIP employed 53 lobbyists in 2023. Of those, 36 previously held government jobs. In 2024, 31 of its 51 lobbyists were former government officials. That is roughly two-thirds of AHIP’s entire lobbying operation consisting of people who used to work for the government entities they now lobby.
3.2 UnitedHealth’s “K Street Army”
A review of lobbying disclosures identified approximately 50 UnitedHealth lobbyists active in 2024, paid a combined $5.86 million. The roster includes former staffers from both parties at the highest levels:
Democratic side: Former chief of staff to House Minority Leader Hakeem Jeffries. Former member services director for Jeffries.
Republican side: Former special assistant to President George W. Bush. Former chief of staff to Sen. Ted Cruz. Former legislative director to Senate Majority Whip John Cornyn.
3.3 The Ballard Partners Connection
In 2025, UnitedHealth Group retained Ballard Partners, the top-earning lobbying firm of the year. Ballard Partners was founded by Brian Ballard, who served as chairman of the Trump Victory PAC in 2016 and 2017. Former Ballard Partners staff now hold senior positions in the Trump administration, including White House Chief of Staff Susie Wiles and Attorney General Pam Bondi.
Federal lobbying spending reached a record $5.08 billion in 2025, up 14% from 2024.
Source: OpenSecrets — AHIP | Star Tribune — UHG Lobbying Investigation | OpenSecrets — Record Lobbying 2025
4. THE SPENDING RATIO
UnitedHealth’s federal lobbying in 2025: $9.93 million (through September 30).
UnitedHealth’s adjusted operating earnings in 2024: $34.4 billion.
The lobbying spend is roughly 0.03% of annual operating earnings. For every dollar spent lobbying, the company earned about $3,465 in operating profit.
For context: the entire pharmaceutical and health products industry spent $452 million on federal lobbying in 2025. Total U.S. lobbying across all industries hit a record $5.08 billion. UnitedHealth’s share of that is 0.2%.
The return on investment is not a theory. It is arithmetic.
Source: OpenSecrets — UnitedHealth Lobbying | UnitedHealth Group 2024 Results
5. THE BIPARTISAN RECEIPT
UnitedHealth Group’s PAC contributions split across both parties. In the 2023-2024 cycle: $4.47 million in total contributions to Democratic and Republican candidates and committees.
The revolving door staffing is bipartisan by design: former Democratic leadership staff and former Republican leadership staff working the same hallways for the same client. Jeffries’ former chief of staff and Cruz’s former chief of staff lobby for the same company.
This is not a left-wing problem. This is not a right-wing problem. The mechanism does not have a party. It has a return address. And the return address is usually a holding company in Delaware.
For the full sourcing behind every claim in this episode, see the Evidence Locker. For how the denial mechanisms work, see the Decoder Ring. For what you can do about it, see Your Move and the TRIDENT Field Card.
| Source | Type | Section |
|---|---|---|
| OpenSecrets: UnitedHealth Group Profile | Primary | 2, 4, 5 |
| OpenSecrets: Cigna Corp Profile | Primary | 2 |
| OpenSecrets: AHIP Profile | Primary | 2, 3 |
| OpenSecrets: Lobbying Trends 2025 | Primary | 3, 4 |
| Star Tribune: UHG Lobbying Investigation (Sep 2025) | Journalism | 3 |
| UnitedHealth Group 2024 Annual Results | Primary | 4 |