March 21, 2023

Reaping Profit After Assisting on Health Law

That means boom times for what might be called an Obamacare cottage industry, providing work for dozens of former administration and mostly Democratic Congressional officials whose immersion in health policy minutiae, and friendships, make them invaluable to private business.

Dr. Dora Hughes, for example, has a medical degree from Vanderbilt and a master’s in public health from Harvard and never envisioned joining a law firm. But Dr. Hughes, a former Obama administration official, has something Washington lawyers and lobbying shops covet: an insider’s understanding of the new health care law.

After nearly four years as counselor to Health and Human Services Secretary Kathleen Sebelius, she left government last year to work for Sidley Austin, which represents insurers, pharmaceutical companies, device makers and others affected by the law. She is not a registered lobbyist, but rather a “strategic adviser,” although some call that a distinction without a difference.

“Health policy is what I do,” Dr. Hughes said in a recent interview. “It’s what I’ve always done, so I’m not doing anything differently. My work is not based only on relationships or trying to curry favor.”

The health care industry now spends more money on lobbying in Washington than any sector of the economy — more than $243 million last year alone, slightly higher than the $242 million spent by financial, insurance and real estate companies, according to the Center for Responsive Politics here.

Of the “revolving door lobbyists” profiled by the center, those specializing in health care account for 12 percent, more than any other economic sector.

Critics say these former officials are cashing in, trading on the relationships and expertise they acquired while working for the taxpayers, and cite such career moves as proof that Mr. Obama has not lived up to his promise to change the culture of influence peddling in the capital.

Liz Fowler, a onetime executive with WellPoint, the insurer, helped draft the legislation as the chief health counsel for the Senate Finance Committee and later joined the administration. Now she runs global health policy for Johnson Johnson, the medical equipment and pharmaceutical giant, which strongly backed the health bill and stands to benefit from it.

Ms. Fowler is not a registered lobbyist, but she does provide in-house advice on the bill — work that has drawn criticism from publications like the British newspaper The Guardian and the Web sites Salon and The Huffington Post, where the journalist Bill Moyers singled out Ms. Fowler, asserting that “when push comes to shove, corporate interests will have the upper hand.”

Yet the progression from government to the private sector is also predictable, a window into the peculiar rhythms of life in the capital. Young aides, often fresh out of college or graduate school, acquire highly specialized knowledge but eventually settle down, build lives and long for jobs that pay more and let them see their children at night.

Those were considerations for Dr. Hughes, who has a 3-year-old, and Yvette Fontenot, a mother of three who began her Washington career in 1997, analyzing Medicare for the Office of Management and Budget. Ms. Fontenot worked on the health bill as a Finance Committee aide and later moved to the White House. Four months ago she joined Avenue Solutions, a boutique lobbying shop.

“Every client out there is interested in the Affordable Care Act and what it means,” said Ms. Fontenot, who like Dr. Hughes concentrates on strategic advice. With exchanges soon to go live, she said, companies “want to know whether there is a potential to build on this, to make changes.”

Many of the former health care officials are lawyers or lobbyists, though not all. Nancy-Ann DeParle, Mr. Obama’s former “health czar” and later his deputy chief of staff, now guides health care investments as a partner in a new private equity firm, Consonance Capital, with colleagues from her pre-White House days. Bob Kocher, a doctor, management consultant and former member of Mr. Obama’s economics team, is a California venture capitalist, helping finance health start-ups.

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