FAIRBANKS — Republican Sen. Lisa Murkowski, who played a pivotal role last week in blocking GOP efforts to replace the Affordable Care Act, received more than $200,000 in contributions from PACs connected to the health care industry for her 2016 re-election campaign, according to a News-Miner review of federal campaign filings.
The $202,500 amounted to 7.5 percent of the nearly $2.7 million in PAC contributions Murkowski’s campaign received during Federal Election Commission reporting from 2011 to 2016, the six years of her previous term.
Among the industries donating to Murkowski, health care is on the lower end, according to the Center for Responsive Politics, which tracks campaign contributions.
Of the $202,500, about 40 percent came from political action committees representing health professionals such as doctors, surgeons, physical therapists and nurse practitioners, according to the News-Miner’s review of records.
The American Medical Association, whose PAC gave $10,000 to Murkowski, has been a leading and consistent opponent of the Senate GOP leadership’s health care bill, the Better Care Reconciliation Act.
Before Senate voting Wednesday, AMA President David O. Barbe said Republican amendments “would harm vulnerable patients in every state.”
Other health-connected PAC funds to Murkowski came from the pharmaceutical, insurance, hospital, nursing home and medical products industries, according to FEC data reviewed by the News-Miner, each with its own concerns about the Affordable Care Act and Republican efforts to replace it.
PACs accounted for almost half of the $5.85 million raised by Murkowski’s re-election campaign. The remainder came from individual donors.
The $202,500 in health-related PAC funds comprised some, but not all, health-sector dollars supporting her re-election. Individuals, some of whom work for companies that also have PACs, donated thousands.
For example, five executives of Premera Blue Cross — the only company providing insurance in Alaska in the government-run insurance marketplace — gave her campaign a combined $8,750. Premera’s PAC donated $9,000.
Until her high-profile opposition to Republican efforts to repeal the ACA during the past few weeks, Murkowski was more widely known outside of Alaska as the chairwoman of the Senate Energy and Natural Resources Committee.
But earlier this year, she became increasingly concerned, vocally so, about how Republican leaders were approaching a replacement for the Affordable Care Act, though she said it did need some reworking.
She has, for example, expressed strong concern about the GOP’s proposed funding reductions for Medicaid and Planned Parenthood and about the pace and process Republicans used to produce draft legislation.
In March, Murkowski was one of four Republican senators who signed a letter to Senate Majority Leader Mitch McConnell, R-Ky., that warned about changing Medicaid, the state-federal program providing health care for about 70 million people — children, pregnant women, low-income adults, the elderly and people with disabilities.
“We believe Medicaid needs to be reformed, but reform should not come at the cost of disruption in access to health care for our country’s most vulnerable and sickest individuals,” according to the letter. “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”
Funding for Medicaid and its expansion — an option under the ACA for states to broaden the program using federal funds, which Gov. Bill Walker accepted in 2015 — would have been reduced sharply under the Senate bill.
Murkowski voted “no” on all four key GOP health care votes last week, including on the initial question of whether to allow debate on the GOP proposal.
Friday’s defeat of McConnell’s “skinny repeal” of the Affordable Care Act means health care will probably be taken up by Senate committees — the very panels McConnell bypassed when he chose to take the measure directly to the Senate floor.
Murkowski is a longtime member of the Health, Education, Labor and Pensions Committee, which likely will help craft health care legislation.
Karina Peterson, Murkowski’s communications director, said campaign contributions don’t factor into Murkowski’s decision making.
“We don’t follow what contributions are made to Murkowski’s campaign, nor does Sen. Murkowski’s office take them into account when considering an issue or taking official action,” she said.
The PAC contributions to Murkowski during 2011-2016 were mostly from the oil and gas, utility, mining and seafood industries, though PACs representing law firms and the defense industry also contributed substantially.
The high number of donations from the energy sector isn’t surprising given Murkowski has been a member of the Energy and Natural Resources Committee since joining the Senate in January 2003. She has chaired the panel since Republicans regained control of the chamber in the 2014 election.
Among health-related organizations giving to Murkowski’s campaign during the six years of her previous term, health professionals were the top group, giving $87,500. That’s 43 percent of the total she received from the health sector.
Twenty-one PACs of health professionals organizations donated to her campaign, representing doctors, surgeons, physical therapists, nurse practitioners, nurse anesthetists, physician assistants, pediatricians, dentists, optometrists, psychologists, osteopaths, midwives, rheumatologists, obstetricians, gynecologists and emergency room physicians.
The AMA PAC gave the most: $10,000 through three contributions. The AMA, the largest association of physicians, had a list of concerns about proposed revisions to the ACA.
The AMA, in a June 26 letter from CEO James L. Madara to McConnell and Democratic Minority Leader Chuck Schumer, expressed concern about proposed changes to Medicaid, about smaller subsidies for people buying insurance in the government-run marketplaces, about the potential state waivers of required benefits, and about a prohibition on individuals using Medicaid coverage at Planned Parenthood clinics.
“We do appreciate the inclusion of several provisions designed to bring short term stability to the individual market, including the extension of cost sharing reductions payments,” Madara wrote. “We urge, however, that these provisions serve as the basis of Senate efforts to improve the ACA and ensure that quality, affordable health insurance coverage is within reach of all Americans.”
The American Association of Nurse Anesthetists gave $10,000 during the six years, with $4,500 of that coming in 2015-16.
The American Physical Therapy Association, whose PAC gave $6,000 to Murkowski, listed several areas of concern with the latest Senate version and earlier this year with the House bill.
The association was especially critical of the bill’s phaseout of Medicaid expansion funding and a provision dropping the requirement that policies cover what are described as “essential health benefits” — 10 categories of service required under the ACA, including ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
Murkowski’s spokeswoman declined to respond to a question seeking Murkowski’s position on required essential health benefits. Murkowski, in a February interview with the News-Miner that included an update on health care legislation, appeared open to some change.
“Lot of discussion about letting the states determine what the essential health benefits looks like,” she said. “And I think that that’s an area where there’s been a lot of, I think, a lot of consensus that that’s something that we can look to also within the ACA.”
The American Association of Nurse Practitioners gave Murkowski $2,000. The organization issued a statement in May after the passage of the House health care bill, urging senators to “take a measured approach ensuring any final legislation protects patient access to Medicaid, Medicare and other programs which cover the cost of care.”
The insurance industry
Murkowski received numerous contributions from insurance companies from 2011-16.
Premera Blue Cross gave Murkowski $9,000 in the six-year period. Calls to Premera Blue Cross seeking comment were not returned.
The Council of Insurance Agents & Brokers gave Murkowski $5,000, the Independent Insurance Agents and Brokers of America gave $1,500, and the National Association of Insurance and Financial Advisers gave $5,000. The three were among the four insurance-related entities listed as signatories to a June 27 letter urging “deep reforms” to the ACA and commending the Senate’s work.
The National Association of Health Underwriters gave $7,500 in four contributions in the six-year period. The organization did not issue a statement on the Senate bill but did provide some support in March for the House’s health care bill.
Insurance companies want Congress to preserve the tax exemption for employer-sponsored health plans — employers and employees do not pay federal taxes on the coverage — and eliminating the so-called “Cadillac tax” on high-cost health plans.
The industry also opposes the annual tax imposed on insurers under the ACA. Congress froze the tax for one year last year in an omnibus budget agreement.
The industry’s leading trade association, America’s Health Care Plans, expressed concern about the health bill rewrite passed by the House in May, saying it needed “important improvements” in the Senate “to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage.”
But a joint letter July 14 to McConnell and Schumer from insurance association President and CEO Marilyn Tavenner and Blue Cross Blue Shield President and CEO Scott Serota criticized McConnell’s draft legislation for its inclusion of a component known as the “Consumer Freedom Option,” authored by GOP Sen. Ted Cruz, of Texas. That component would allow insurers to offer bare-bones policies attractive to healthy people as long as they also offer comprehensive policies that comply with the current law regarding the inclusion of essential health benefits.
“As healthy people move to the less-regulated plans, those with significant medical needs will have no choice but to stay in the comprehensive plans, and premiums will skyrocket for people with pre-existing conditions,” the two-page letter reads. “This would especially impact middle-income families that are not eligible for a tax credit.”
Serota contributed $1,000 to Murkowski’s campaign in October 2016.
Murkowski’s office did not respond to a question seeking Murkowski’s position on the Cruz amendment.
Drug, biotech industries
The pharmaceutical industry has been lobbying for repeal of an ACA tax on brand-name prescription drugs. The tax is one of the means by which the federal government pays for the subsidies that help individuals buy insurance coverage through the government-run marketplaces.
Murkowski supports repealing tax, Peterson said in an emailed response to questions.
“The senator supports the repeal of that component under the ACA,” Peterson wrote. “The increased tax on prescription drugs obviously impacts the amount a patient pays for those drugs. Prescription drug prices are far too high, and the Senate should take reasonable actions to bring those prices down, including by repealing this tax.”
Murkowski’s list of PAC donors for her 2016 campaign includes some widely recognizable drug company names: Pfizer, Johnson & Johnson and Merck.
The list also includes PACs of some pharmaceutical companies that may be lesser known and whose parent corporations are foreign-based. They include Teva Pharmaceuticals, based in Israel; Novo Nordisk, based in Denmark; and Novartis, out of Switzerland. Each has a U.S. division.
Foreign-based companies can contribute to U.S. candidates only through PACs set up by their U.S. subsidiaries or divisions. And those PACs can only accept donations from employees who are U.S. citizens or legal residents.
Others pharmaceutical industry PACs contributing to Murkowski included the National Association of Chain Drug Stores, Consumer Health Care Products Association, Association for Accessible Medicines, Hologic Gen-Probe Inc., McKesson Corp., Merit Medical Systems Inc., and Pharmavite LLC.
The American Hospital Association was the leading Murkowski donor among hospital and nursing home PACs, giving $10,000 of the $14,000 given by this group of contributors.
The AHA opposed the bill passed by the House and opposed the most recent Senate draft legislation. A top concern cited by the AHA is the proposed reduction in Medicaid funding and the possibility the number of uninsured people would again increase — and that those people would head to hospital emergency rooms for care and then be unable to pay.
Hospitals bank on an increased number of insured people using services to offset payment reductions enacted under the ACA, such as annual inflation updates and certain Medicare and Medicaid payments.
Dr. Greg Johnson, the chief executive of Foundation Health Partners, which operates Fairbanks Memorial Hospital, said in a News-Miner interview in June that he would expect an increased use of the hospital’s emergency room and a higher cost for services if McConnell’s bill were to become law.
The Alaska State Hospital and Nursing Home Association opposed the initial draft Senate bill, citing its Medicaid reduction and its reduction in the availability of tax credits for those wanting to buy insurance through a government-run marketplace.
“Denying people affordable coverage doesn’t improve the system, it only reduces access to necessary health services and drives up the cost care for all. This bill moves Alaska in the wrong direction,” association President and CEO Becky Hultberg said in a July 22 news release that also noted people without insurance turn to hospital emergency rooms for care.
Donations from individuals
The thousands of records of contributions from individual donors directly to Murkowski’s campaign are not sorted by industry sector because that information is not provided on the individual FEC transaction records. In many instances, however, the employer name and employee position are identified, allowing some tracking.
For example, several executives at Premera Blue Cross gave $8,750 directly to Murkowski’s campaign in 2015-16, the period of heaviest fundraising by her campaign.
Jeffrey Roe, Premera’s CEO and president, gave $5,000; Katharine Cramer, executive vice president, chief legal and risk officer, gave $1,000; Lynn Rust Henderson, vice president of sales and service for Premera in Alaska, gave $1,000; Cecily Hall, senior vice president, human resources, gave $1,000; and former Premera Vice President and General Manager James Havens gave $750.
Only one of them made a contribution in the first four years of Murkowski’s term — Henderson, for $300.
Officials at Moda Health, which was one of two companies offering insurance through the government-run insurance marketplace until it pulled out earlier this year, also have given to Murkowski’s campaign. Seven Moda officials gave a combined $9,950 to Murkowski’s campaign, all of it in 2015-16. CEO Robert Gootee gave $3,200; Senior Vice President Robin Richardson, $2,000; James Francesconi, vice president of public policy, $1,500; Senior Vice President Dave Evans, $1,000; Senior Vice President Kraig Anderson, $1,000, Alaska Director Jason Gootee, $1,000; and Mary Lou True, vice president of human resources, $250.
Moda Health has been lobbying Congress to continue risk-reduction provisions such as those contained in the ACA, “specifically implementation of risk corridors and reinsurance programs,” according to lobbying reports filed with the FEC.
Murkowski has been “very supportive” of reinsurance, according to her spokeswoman. Reinsurance is a program intended to be temporary as a way to reduce premiums in higher-risk markets under the ACA. The program is administered by the federal government, which redistributes funds collected from all insurers for this purpose.
Alaska earlier this month received a federal waiver from requirements of the ACA so it could implement its own reinsurance program.
Contact News-Miner Editor Rod Boyce at 459-7585. Follow him on Twitter: @FDNMeditor.