Why It Matters

The Children's Hospital Association filed a first quarter 2026 lobbying disclosure reporting $1.44 million in federal lobbying expenditures as the organization faces one of the most consequential federal budget debates in recent memory for pediatric healthcare.

Children's hospitals rely heavily on Medicaid funding, and the proposed federal reconciliation legislation of the "One Big Beautiful Bill Act" could cut more than $1 trillion from the program. For hospitals where Medicaid covers the majority of patients, those cuts could mean service reductions, staffing cuts, and longer wait times.

The Association's lobbying footprint reflects the scale of what's at stake: a sustained, multi-front engagement on Capitol Hill covering insurance coverage, graduate medical education funding, and pediatric workforce policy.

By the Numbers: A Closer Look at the Lobbying Disclosure

The first quarter 2026 filing reports $1.44 million in lobbying expenditures. That figure is down from a peak of $1.97 million in the third quarter of 2025, but up from $1.28 million in the fourth quarter of 2025.

This is one of several lobbying disclosures filed on behalf of the Association. In addition to this primary in-house disclosure, the organization has used multiple outside firms in recent quarters, with separate filings from those firms reporting additional expenditures. Across all filings covering the past year, total lobbying expenditures attributed to the Children's Hospital Association exceeded $10 million.

The eight lobbyists listed on this primary disclosure are all in-house and have worked consistently for the association across multiple quarters:

  • Darian Burrell-Clay
  • Aimee Ossman
  • Kaleigh Koudela
  • Jared Lee
  • Jan Kaplan
  • Natalie Torentinos
  • Elizabeth Brown
  • Cynthia Whitney

Most of these lobbyists have appeared on the association's filings going back to at least early 2024. There are no new additions to the team in this disclosure, and no outside firms are listed on this particular filing. The lobbying team is stable and experienced, with several members appearing on every quarterly disclosure in the past two years.

The Agenda: What the Lobbying Disclosure Shows

The first quarter 2026 filing does not list any specific issues or legislation in the disclosure's issues field, which is left blank. Prior quarterly disclosures from the same organization, however, provide a clear picture of the Association's consistent legislative focus.

In recent quarters, the Association has lobbied on:

  • Children's health care coverage and access under Medicaid, CHIP, the Exchanges, TRICARE, and private insurance
  • Implementation of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements under Medicaid
  • Health care delivery for children covered by TRICARE
  • Funding for the Health Resources and Services Administration (HRSA), including the Children's Hospitals Graduate Medical Education (CHGME) program
  • Graduate medical education more broadly
  • Issues related to H.R. 1, the "One Big Beautiful Bill Act," specifically Medicaid provisions affecting children's health care

Legislation referenced in prior filings includes the Youth Mental Health Research Act, the Accelerating Kids' Access to Care Act, and appropriations legislation covering health and human services agencies.

Broader Context

The association's lobbying activity is unfolding against a backdrop of significant federal policy pressure on children's hospitals. In late March 2026, the association launched a campaign called "Put Kids First," running advertising throughout the Washington, D.C. area. CEO Matthew Cook stated publicly that federal funding and policies are "falling short, making it a constant battle for children's hospitals and staff to do what they do best: protect children's health."

The proposed reconciliation legislation has drawn particular attention. The Congressional Budget Office has projected that the bill's Medicaid provisions could result in 9.1 million more uninsured individuals by 2034. Cook has said publicly that the organization may need to reconsider some of its services if cuts move forward.

The CHGME program, which funds the training of pediatric physicians at children's hospitals, was proposed for elimination in the President's fiscal year 2026 budget request. The association has formally opposed that proposal.

Members of Congress have engaged directly with children's hospitals on these issues. Rep. Brian Fitzpatrick (R-PA) noted in January 2026 that "the widening gap between rising costs and Medicaid shortfalls is pushing even our strongest safety-net hospitals to a breaking point," and cited co-sponsorship of the Accelerating Kids' Access to Care Act as part of his response. Rep. Nikema Williams (D-GA) highlighted that 71 percent of children in the neonatal intensive care unit at Children's Healthcare of Atlanta are covered by Medicaid, underscoring the stakes of proposed cuts. Sen. Patty Murray (D-WA) directly amplified the association's own messaging on social media, quoting the organization's warning that proposed cuts could mean "fewer doctors and nurses to see your child, longer wait times, and sicker children."

Competitive Landscape

Several other organizations have filed lobbying disclosures on issues that overlap with the Association's priorities. Children's Hospital Colorado has lobbied on TRICARE reimbursements, Medicaid benefits, and pediatric mental and behavioral health. Individual children's hospitals, including those in Pennsylvania and Illinois, have retained outside lobbying firms to work on CHGME funding, Medicaid reimbursement, and pediatric workforce issues. The American Academy of Child and Adolescent Psychiatry has also been active on children's mental health legislation and workforce issues.

The Bottom Line

The Children's Hospital Association's first quarter 2026 lobbying disclosure reflects a well-resourced, consistent operation focused on protecting federal funding streams that children's hospitals depend on. The blank issues field in this particular filing means the specific legislative targets for this quarter are not publicly detailed, but the organization's prior filings and public advocacy make its priorities clear. With Medicaid, CHGME, and pediatric workforce policy all in active congressional play, the association is unlikely to reduce its engagement anytime soon.

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