Why it matters: The American Hospital Association (AHA) has significantly increased its lobbying investment to $7.03 million in Q1 2025, up 7% from the previous quarter, as Congress tackles critical healthcare legislation affecting hospitals nationwide.
The big picture: AHA’s lobbying expenditure is well above its historical quarterly average of $5.31 million, signaling heightened focus as hospitals face workforce challenges, reimbursement pressures, and rural healthcare sustainability issues.
By the numbers:
- $7,030,000 spent on in-house federal lobbying activities in Q1 2025
- 7.0% increase from Q4 2024 ($6,570,000)
- 17 years of consistent in-house lobbying presence since at least 2008
Workforce crisis dominates agenda:
AHA is pushing several bills aimed at addressing the healthcare staffing shortage, including:
- Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R.929/S.266) to support provider mental health
- Conrad State 30 and Physician Access Reauthorization Act (H.R.1585/S.709) to retain foreign medical graduates in underserved areas
- Draft bills on mental health infrastructure, physician shortages, and Medicare Graduate Medical Education program changes
Rural hospital survival at stake:
The AHA is advocating for multiple rural healthcare bills, including:
- Rural Hospital Support Act (S.335) to make permanent certain Medicare payment adjustments
- Assistance for Rural Community Hospitals Act (H.R.1805) to extend critical Medicare payments
- Rural Health Care Technical Assistance Program Act (H.R.1417) to expand USDA’s rural hospital assistance
Medicare financing battles:
AHA is fighting to protect hospital reimbursement by lobbying on:
- Securing Access to Care for Seniors in Critical Condition Act (H.R.1924) to exempt certain long-term care hospitals from site-neutral payment rates
- CMS’s 2026 Medicare Advantage and Part D proposed rules
- MedPAC discussions on payment systems across healthcare settings
Between the lines: AHA’s expanded lobbying comes as hospitals face unprecedented financial pressures from staffing costs, Medicare reimbursement challenges, and rural facility closures.
Lobbying firepower: The association’s experienced in-house team includes:
- Roslyne Debbie Weiner Schulman (lobbying since 1999)
- Lisa Kidder Hrobsky (since 2002), with Senate Special Committee on Aging experience
- Ashley B. Thompson (since 2002), former Senate Finance Committee Health Policy Advisor
Competition landscape: AHA is navigating a crowded lobbying field that includes:
- American Medical Association on physician payment issues
- Federation of American Hospitals on rural hospital support
- AARP and Campaign for Sustainable Drug Pricing on pharmaceutical costs
- Service Employees International Union on staffing requirements
What’s next: Most bills remain in committee, with the AHA focused on building congressional support as these measures advance through the legislative process.