Thursday, March 15, 2018

In "Trump Town," the Revolving Door Runneth Over: Yet More Ex-Lobbyists as Political Appointees at the Department of Health and Human Services

We have accumulated a remarkable number of stories of people transiting the revolving door from high-level positions in health care corporations to high-level positions in health care policy or regulation for the Trump administration.  These stories may not always appear in the most prominent places, but their accumulation suggests they should be of prominent importance.

ProPublica's "Trump Town" Project

ProPublica has just made public its massive "Trump Town" project.  An accompanying article explains it thus,

When the Trump administration took office early last year, hundreds of staffers from lobbying firms, conservative think tanks and Trump campaign groups began pouring into the very agencies they once lobbied or whose work they once opposed.

Today we’re making available, for the first time, an authoritative searchable database of 2,475 political appointees, including Trump’s Cabinet, staffers in the White House and senior officials within the government, along with their federal lobbying and financial records. Trump Town is the result of a year spent filing hundreds of Freedom of Information Act requests; collecting and organizing staffing lists; and compiling, sifting through and publishing thousands of financial disclosure reports.

Here’s what we found: At least 187 Trump political appointees have been federal lobbyists, and despite President Trump’s campaign pledge to 'drain the swamp,' many are now overseeing the industries they once lobbied on behalf of. We’ve also discovered ethics waivers that allow Trump staffers to work on subjects in which they have financial conflicts of interest.

In other words, 'Trump Town' offers a detailed view of the most massive and far-reaching campaign to instill conflicted corporate insiders into federal agencies ever attempted.  For years, we at Health Care Renewal have been trying to highlight particular instances of people who transit the revolving door to or from US government agencies involved with health care.  We stepped up this effort when we realized that the Trump administration seemed intent on moving a record number of people from the health care "industry" to positions within the government which could regulate or influence policy affecting that industry.  But ProPublica has shown there were far more such people than we dreamed of.

The Latest Crop of Revolving Door Travelers Publicly Revealed

So here we will review people listed in the ProPublica database who went from lobbying for the health care "industry" to the Department of Health and Human Services (DHHS) under the Trump administration.  We will emphasize those whom we have not yet previously discussed.  In alphabetical order:

John J. Bartrum
Assistant Secretary for Financial Resources

Former Partner, Squire Patton Boggs

Former Compensation Sources

American International Group (AIG), Inc. Legal Services
Biotechnology Industry Organization (BIO) Legal Services
Cadmus Group Legal Services
Management & Training Corp (MTC) Legal and Lobbying Services
Micropact Legal and Lobbying Services
Squire Patton Boggs LLP (US) Partner, Attorney
The Coca Cola Company Legal Services
Thomas Jefferson University Hospital Legal Services
University of Georgia (UGA) Legal Services

Kimberly L. Brandt
Principal Deputy Administrator for Operations | $179,700

Lobbied for


Robert Charrow
General Counsel

from Greenberg Taurig LLP and Registered Lobbyist, Intrexon Corp to General Counsel, DHHS, see this post

Shannon Christian
Director, Office of Child Care | $150,000

Former Compensation Sources

BLH Technologies, Inc. Development/training re: online communications system, and meeting/membership support for Child Care Policy Research Consortium, a project of OPRE, ACF, HHS

Kelly Marie Cleary
Chief Legal Counsel, Centers for Medicare and Medicaid Services | $179,700

Former Positions Outside Government

Akin Gump Strauss Hauer & Feld LLP Attorney

Lobbied for

Alameda Alliance for Health
California Association of Physician Groups
Catalina Marketing
Guardian Life Insurance Company
Gundersen Lutheran Medical Foundation
Johnson & Johnson
Network for Regional Healthcare Improvement
ThedaCare Center for Healthcare Value
Wisconsin Medical Society

Eric D Hargan
Senior Adviser to the Secretary, Deputy Secretary, Health and Human Services

from from Lobbying for UnitedHealthcare for Greenberg Traurig Alston & Bird to Deputy Secretary, DHHS, see this post

Jenifer Lynn Healy
Chief of Staff, Office of Global Affairs | $161,900

Lobbied for

Adapt Pharma
American College Health Association
American Osteopathic Association
Bay Area Council
Braeburn Pharmaceuticals, Inc.
Coalition to Advance Medical Resident Training in Community Hospitals
Friends of the Global Fight
General Genetics Corporation
International Contrast Ultrasound Society
Kognito Solutions, LLC
L.A. Care Health Plan
Local Health Plans of California, A state wide trade association that represents publicly- financed, not-for-profit health
Maximus, Inc., Healthcare and business services company.
Mobilex USA
Physicians and Surgeons Association of Puerto Rico
Voices for National Service

Laura Holland Kemper
Deputy Assistant Secretary for Legislation (Public Health and Science) | $179,700

Lobbied for

American Academy of Adoption Attorneys
American Academy of Family Physicians
Association of Air Medical Services
C2C Solutions, Inc.
 Caravan Health (formerly known as The National Rural ACO)
Federal Hearings & Appeals Services, Inc.
 Horty, Springer & Mattern
ICOT Hearing Systems LLC
National Academy of Elder Law Attorneys, Inc.
National Association for the Support of Long Term Care, Trade assoc. representing ancillary of services and products to post-acute care settings
National Association of Community Health Centers
 Society of Hospital Medicine
U.S. Renal Care
Vital Decisions, LLC

Sery Kim
Senior Advisor | $149,337

Lobbied for

Budco Health Service Solutions
Dutko Grayling (on behalf of HSA Bank)

Courtney Austin Lawrence
Deputy Assistant Secretary for Legislation (Human Services) | $155,000

Lobbied for


Lance Leggitt
Senior Advisor to the Secretary | Chief of Staff | SES

from Baker Donelson Bearman Caldwell & Berkowitz to Chief of Staff for the Secretary of DHHS, see this post.

Keagan Resler Lenihan
enior Advisor to the Secretary | Senior Counselor to the Secretary | $179,700 |

a director of government relations at McKesson Specialty Health, a firm that supports independent health providers. Disclosure records show Lenihan directly lobbied HHS, see this post.

Christopher Edward Meekins
Senior Advisor, Office of the Assistant Secretary for Preparedness and Response | $161,900

Former Compensation Sources
FBR Capital Markets: Offered investment advice based on analysis of policy actions occurring in Washington, D.C.

 Lobbied for

American Society of Anesthesiologists

Sara Nur Morse
Deputy Assistant Secretary for Legislation (Congressional Liaison) | $155,000

Lobbied for

American College of Surgeons
American College of Surgeons Professional Association

Maya Michelle Noronha
Special Advisor, Office of Civil Rights | $131,767

Maya M. Noronha is an associate at Baker & Hostetler LLP in Washington, D.C. As a member of the Political Law Team, she focuses on redistricting litigation, voting rights cases, and campaign finance law. She has advised Members of Congress, federal candidates, state officials, state legislatures, campaigns, and political committees on election law. Ms. Noronha also works on Baker & Hostetler’s Public Policy Team, where she analyzes Congressional legislation and executive branch priorities to advise clients on political affairs.

Ashley Morgan Palmer
Deputy Assistant Secretary for Legislation (Health Care Reform) | $124,406

Lobbied for

Health Industry Distributors Association

Rebecca Kathleen Wood
Chief Legal Counsel FDA | $179,700

Former Positions Outside Government

Sidley Austin LLP Partner

Former Compensation Sources

AT&T Corp. Legal services
AbbVie, Inc. Legal services
American Chemistry Council Legal services
Arthrex, Inc. Legal services
Association Of American Railroads Legal services
Baker & McKenzie LLP Legal services
Bayer Pharma Legal services
Bayer USA Legal services
CSX Transportation, Inc. Legal services
 Duke Energy Corporation Legal services
Electric Insurance Company Legal services
Helmerich & Payne, Incorporated Legal services
 Medical Information Working Group Legal services
 NII Holdings Legal services N
ew Enterprise Asociates Legal services
Norfolk Southern Corp. Legal services
PhRMA Legal services
Sidly Austin LLP Legal services
St. Jude Medical, Inc. Legal services
The Timberland Company Legal services
Union Pacific Railroad Company Legal services


On and on it goes.  The revolving door has been a chronic problem for the US federal government, but the level of revolving door activity in the current regime seems way beyond anything we have seen before.  It seems we chronical multiple instances of people going from important health care corporate positions to government positions that regulate or make policy affecting those same corporations for every instance of someone coming from the previous administrations to industry.

So, as I have said before, e.g.,  in August, 2017,

The revolving door is a species of conflict of interest. Worse, some experts have suggested that the revolving door is in fact corruption.  As we noted here, the experts from the distinguished European anti-corruption group U4 wrote,
The literature makes clear that the revolving door process is a source of valuable political connections for private firms. But it generates corruption risks and has strong distortionary effects on the economy, especially when this power is concentrated within a few firms.

The ongoing parade of people transiting the revolving door from industry to the Trump administration once again suggests how the revolving door may enable certain of those with private vested interests to have excess influence, way beyond that of ordinary citizens, on how the government works, and that the country is still increasingly being run by a cozy group of insiders with ties to both government and industry. This has been termed crony capitalism. The latest cohort of revolving door transits suggests that regulatory capture is likely to become much worse in the near future.

Remember to ask: cui bono? Who benefits? The net results are that big health care corporations increasingly control the governmental regulatory and policy apparatus.  This will doubtless first benefit the top leadership and owners/ stockholders (when applicable) of these organizations, who are sometimes the same people, due to detriment of patients' and the public's health, the pocketbooks of tax-payers, and the values and ideals of health care professionals.  

So, as we have said before [before, before...] The continuing egregiousness of the revolving door in health care shows how health care leadership can play mutually beneficial games, regardless of the their effects on patients' and the public's health.  Once again, true health care reform would cut the ties between government and corporate leaders and their cronies that have lead to government of, for and by corporate executives rather than the people at large.


Judy B said...

I am very discouraged!

Roy M. Poses MD said...

Don't get discouraged. Get angry.

I just wrote what appears below to some friends and relatives. I think it applies here:


I still think if everyone does something, even something small, there can be a cumulative effect.

I think apathy, learned helplessness, the attitudes that my vote doesn't matter, that all politicians are bad, that voting is about protest, but not about getting the best (even of bad alternatives) elected, all led us to where we are now, and thus enabled this sort of corruption and need to be reversed.

At least: speak out in some way. Go to town hall meetings. Write letters to the editor. Use social media. Participate in a demonstration. For gosh sake, make sure you are registered and make sure to vote. (So far, for what it's worth, I have done all but participate in a demonstration, so far.)

If you know anyone who disagrees with you or is on the fence, but will listen to you, try to persuade that person, gently maybe. If you know anyone with clout, see if you can talk to them.

Find some particular little part of this puzzle that particularly bothers you and try to direct some efforts to solving it, even if small.

Also some advice from our state congressional delegation in a recent Town Hall: You may get tired. You may get discouraged. If you need to, take a day off, take a week off. But then come back.

Judy B said...

I have done everything except march. I will continue writing and calling.