Why It Matters

The Children’s Hospital Association faces an existential fiscal threat that makes Q3 2025 lobbying activity critical. The 2025 federal budget reconciliation law imposes approximately $911 billion in Medicaid cuts over the next decade, directly threatening children’s hospitals that depend on Medicaid for roughly half their revenue.

Phoenix Children’s Hospital alone faces $172 million in annual losses once state-directed payment caps phase in starting 2028.

There are early bipartisan signals of openness to revisions—Senator Josh Hawley introduced legislation within days of voting for reconciliation to prevent Medicaid payment cuts to hospitals.

By the Numbers

The Children’s Hospital Association spent $1,970,000 in Q3 2025 on in-house lobbying, managed by an eight-member internal team. Historically, CHA has filed 421 disclosures since 2003, totaling over $82 million in reported expenditures.

The lobbying team includes three members with direct congressional experience: Elizabeth A. Brown brings 16 years and 1 month of House service, Darian J. Burrell-Clay served 2 years and 4 months as a Senate Legislative Assistant, and Kaleigh Callis Koudela brings 3 years and 1 month of Republican House experience.

Five additional lobbyists round out the team, including Natalie Torentinos and Cynthia Whitney, who bring expertise from the American College of Cardiology and American Academy of Child and Adolescent Psychiatry respectively.

The Agenda

The Children’s Hospital Association is lobbying on several specific issues central to pediatric healthcare policy. Key priorities include securing federal funding for the Children’s Hospitals Graduate Medical Education (CHGME) program, expanding Medicaid and CHIP coverage for children, protecting the 340B Drug Pricing Program, and addressing the pediatric mental health crisis. The organization’s Q3 2025 lobbying aligns with active congressional consideration of mental health infrastructure funding, streamlined Medicaid access for children with complex medical needs, and reauthorization of pediatric workforce training programs.

Broader Context

Children’s hospitals face convergent fiscal and policy pressures driving CHA’s aggressive Q3 lobbying spend. Beyond the reconciliation law’s Medicaid cuts, the Trump administration cut $1 billion in school-based mental health services grants and capped Rural Health Transformation Fund grants at 15%, further straining pediatric infrastructure.

However, Congress shows genuine bipartisan engagement on CHA’s core priorities. Nearly 1 in 10 children on Medicaid visit emergency departments for mental health care, creating legislative appetite for infrastructure funding. Senators Chuck Grassley (R-IA) and Michael Bennet (D-CO) are leading the Accelerating Kids’ Access to Care Act to streamline Medicaid enrollment, while early signals suggest bipartisan receptivity to revising reconciliation provisions affecting pediatric hospitals.

Between The Lines

Congress is actively addressing many of CHA’s priorities amid fiscal headwinds. The Mental Health Infrastructure Improvement Act of 2025 and Accelerating Kids’ Access to Care Act align with CHA’s agenda. Recent hearings on healthcare workforce development and HHS budget directly support CHA’s priorities, with key advocates including Senators Grassley and Bennet on Medicaid access.

The Bottom Line

CHA faces a pivotal moment requiring aggressive federal advocacy. The reconciliation law threatens substantial Medicaid cuts while Congress actively considers legislation on CHA’s core priorities. Early bipartisan signals suggest openness to modifying reconciliation provisions affecting pediatric hospitals. The $1.97 million quarterly expenditure reflects these high stakes, with appropriations and reconciliation implementation decisions over the next 12-18 months substantially determining member hospital viability.

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