Major health plans and industry organizations increased their lobbying expenditures by 23% in the first quarter of 2025 compared to the same period in 2024, according to data compiled by OpenSecrets. Leading the spending surge were Blue Cross Blue Shield plans, AHIP, The Cigna Group, and UnitedHealth Group.
The spike in lobbying comes as President Donald Trump, now in his second term, focuses his health care agenda on reversing several Biden-era policies — particularly those involving the Affordable Care Act and Medicaid. Since January, lobbyists representing health insurers and insurance agents have invested millions in influencing federal policy.
Blues plans reported record-high quarterly lobbying expenditures, spending over $9.1 million in the first quarter of 2025 and collectively ranking as the top individual lobbying spender among the major health plans. Among all BCBS affiliates, Elevance Health, Inc. and Health Care Service Corp. led in lobbying investment.
Blues plans lobbied heavily for key legislations, including the Lower Costs, More Transparency Act (H.R.5378), SITE Act (S.1869), and FAIR Act (H.R.3417). These bills aim to promote site-neutral Medicare reimbursement and expand price and billing transparency for payers. Collectively, BCBS entities hired 114 lobbyists in the first quarter, with 65.8% of whom previously held positions in the federal government.
AHIP, the trade group representing health insurance companies, spent more than $4.8 million in the first quarter. Kaiser Permanente invested nearly $3.1 million, more than doubling its total lobbying expenditures for all of 2024. The group spent $3 million on Health Care Affordability Act of 2025 (H.R.247 and S.46). In addition to health coverage-related issues, Kaiser spent $60,000 on lobbying efforts related to value-based care and the appropriate use of artificial intelligence in health care, according to its public filing.
Lobbying expenditures in the health services/health maintenance organizations (HMO) sector have risen steadily over the past decade, though the industry saw an 8.8% year-over-year decline in 2024. OpenSecrets includes a variety of non-residential health care programs and health maintenance organizations in the sector. Several major health insurers are categorized separately, as part of the insurance industry, on OpenSecrets, and BCBS was listed in both industries. This analysis combined the lobbying spending by BCBS from both industries.