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Top Health Care Companies Spent More Than Half Million On Congressional Trips

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Over the past eight years, some of the largest and most politically active pharmaceutical and health care companies have spent hundreds of thousands of dollars on private trips for members of Congress and their staffs.

All of the trips were described as fact-finding missions, designed to put legislators and their aides in touch with the issues they handle and people they represent. But others have interpreted them far more skeptically -- as the equivalent of out-of-session lobbying, where industry executives cozy up with policy makers in fancy and exotic locales. The pharmaceutical and private health care industries have been some of the most active financiers of these excursions.

A review of hundreds of public documents by the Huffington Post shows that from 2000 through 2008 the top 20 most active companies in these fields sponsored 192 trips worth more than $380,000 for dozens of politicians and staff. The list of those companies -- as determined by campaign contributions in the last election cycle -- include industry giants such as Pfizer, Eli Lilly, GlaxoSmithKline, and Merck & Co.

During that same time period, the Pharmaceutical Research and Manufacturers of America, which represents the country's largest drug manufacturers, spent more than $140,000 sponsoring 66 trips of its own. Meanwhile, the Healthcare Leader Council, a coalition of hospitals, health plans, and pharmaceutical companies spent nearly $70,000 on 49 trips. (Some of these events were co-sponsored.)

While a majority of the travel took place several years ago, all of the groups involved currently have major stakes in today's health care reform debate. The pharmaceutical and health products industry as a whole has, in 2009 alone, already spent more than $66.5 million lobbying Congress. PhRMA, in particular, has come out against plans for a public option for insurance coverage. And as these groups with a vested interest in the outcome of the debate gear up for a summer of legislative combat, groups who follow money in politics worry that sponsorship of congressional travel may give some a leg up on the competition.

"When members of Congress and their staffs spend every day during the week when Congress is in session listening to lobbyists and executives making the case, that is one thing," said David Donnelly of Public Campaign. "But when they go on vacation, which is basically what these trips are, and spend their time going to resorts or hanging around lobbyists or executives in the health care industries, the voices of citizens aren't anywhere in that process."

For years now, the issue of privately funded congressional travel has evoked heated debate. Those in favor of the practice -- in which private industry is allowed to sponsor trips for educational purposes -- say it is necessary to get lawmakers outside the confines of the Beltway bubble. Without adequate funds, they argue, officials wouldn't be able to see the on-the-ground problems they are being asked to tackle. But the trips, even proponents acknowledge, have been abused -- most famously by uber-lobbyist Jack Abramoff, who essentially sponsored travel as a way to repay lawmakers for legislative favors.

The problem, according to Sheila Krumholz, executive director of the Center for Responsive Politics, is that the travel is often structured to win the favor of those doing the traveling. The lawmaker or aide is held captive to their surroundings, she explained: "Typically they are brought to a place and then they are wined and dined. There will be an educational element and then a casual one. And so they get to have their undivided attention for a long period of time."

Those dynamics certainly seemed to hold true when it was private health care industry doing the sponsoring. Among the destinations of trips taken by members of Congress and their aides included San Juan, Puerto Rico, St. Thomas, St. Croix, and the Virgin Islands, Belgium, Brazil and Rome. Domestically, there were stops in Las Vegas, Miami, Park City, Utah, and San Diego. Often, however, it is not only the destination of the trip that stands out, but the cumulative cost of the flight, hotel, and meals covered by the sponsor.

In February 2004, the pharmaceutical company GlaxoSmithKline flew Sen. Orrin Hatch (R-Utah) to Houston, Texas, so that he could attend and speak at a company retreat. The flight for that one-day trip cost a total of $1,048. Although the records don't specify, the tab seems to suggest that Hatch traveled via company jet, perhaps with company executives in tow.

A year earlier, a staffer to Rep. Eric Cantor (R-Va.), Colleen Maloney, went on a two-day trip to San Francisco for what was listed as a "facilities tour." The sponsor of that trip, PhRMA, spent $2,673 on her flight. Later that year, Maloney, who has since left the office, took a three-day trip to San Diego sponsored by the Healthcare Leadership Council, in which she racked up a $1,690 bill for meal expenses.

It wasn't just Republicans. In April 2004, one of Nebraska Sen. Ben Nelson's staffers took a three-day trip to Puerto Rico that was sponsored by the Federation of American Hospitals, a coalition of investor-owned or managed community hospitals that has pledged to reduce costs associated with care but also expressed concerns with Obama's proposals. The $535 transportation bill for that trip was dwarfed by the cost incurred for lodging expenses -- $1,145.

Meanwhile, a staffer to Sen. Max Baucus (D-Mont.) took a three-day trip in 2001 to Las Vegas, Nevada, that was sponsored by the pharmaceutical company Merck-Medco. The cost of that "facility visit" was $3,148, including $1,827 for transportation expenses.

"[Sponsors] get a chance to buttonhole specific members or aides who have jurisdiction over their issues while on these trips," Krumholz explained. "They get really high-quality time. It is often designed to be in a low key, or casual, in an entertaining atmosphere without the social cues that makes it seem like business..."

To be sure, not all sponsored travel is of questionable nature. The Alliance for Health Reform, for example, has sponsored a host of trips for congressional aides to attend its annual conference in Baltimore. Those trips usually involve hopping on a train and attending a day-long conference, replete with panel discussions and legislation briefings.

"We do a retreat every year for congressional staff," said Bill Erwin, communications director of the Alliance, a nonpartisan, nonprofit group that promotes discussion and debate on health care policy. "It's about five alliance briefings in the space of a day. Two or three speakers and a couple of congressional actors."

But with many of the sponsors, Krumholz notes, the goal is to "develop a personal long-term relationship" that could benefit a company months or years after actual trip took place. Often, it is a congressional staffer and not the congressman him or herself whose travel is sponsored. But that does not diminish the significance of these events, observers say. Aides increasingly play vital roles in crafting legislation. And on topics like health care, which touches the jurisdiction of many committees, their role has been elevated even further.

To that point, it is not surprising that some of the key Senate offices currently playing major roles crafting health care reform also had a variety of private health care industry companies pay for trips. From 2000 through 2008, the office of Sen. Mike Enzi (R-Wyo.) -- Ranking Member of the Senate Health, Education, Labor and Pensions (HELP) Committee -- was treated to 14 trips, at a total cost of more than $13,000. Some seemed clearly educational, such as an expedition to India sponsored by the Global Health Council to discuss care in those countries. Others, however, were paid for by companies who stand to benefit from legislation, like the Cook Group, the Medical Device Manufacturers Association and the Healthcare Leadership Council.

On the other side of the aisle is Baucus, who is playing a key role in health care reform from his perch on the Senate Finance Committee. Aides to the Montana Democrat took 35 trips sponsored by health care-related organizations -- the majority nonprofit groups -- at a cost of more than $30,000 from 2000 through 2008. None, it should be noted, came before Baucus took over the role of Finance Committee chairman.

Before leaving Baucus' staff in 2006, Elizabeth Fowler, a longtime aide to the senator on health care issues, took seven of those trips at a cost of more than $8,600. Some were sponsored by non-profits, others not. In 2008, Fowler returned to the office to serve as senior counsel to the Finance Committee after it became clear that Congress would be considering health care and Baucus would be assuming a leading role. In between she held a job with Wellpoint, the nation's second-largest health insurance and HMO Company.

"Senator Baucus is a leader in ethics reforms in the Senate," said the Senator's spokesman Tyler Matsdorf. "Nearly two years before the Senate instituted ethics reforms, he voluntarily imposed one of the strictest ethics policies in Congress. He has instituted bans far beyond what Senate Ethics rules require, including a ban on all gifts, meals and third-party travel except for nonprofit, nonpolitical organizations and a policy that all Finance Committee staff trips would be paid out of the Committee's own travel budget. These rules were instituted before he became Chairman and that's why no trips from outside groups have occurred in the past three plus years and why his Committee staff has not traveled on outside-funded trips since he became Chairman in January 2007."

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