[link removed] [[link removed]] DECEMBER 11, 2025
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The Trump administration is considering a shift toward privatization of veterans' health care, spurring significant spending by companies and industries that could benefit (or not). Plus, a look at the countries that spend the most on lobbying in the United States.
How money is driving the push to privatize veterans’ health care
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Health care companies and legislators are presiding over a shift toward privatized veterans’ care [[link removed]] , attracting support from prominent Republicans including Defense Secretary Pete Hegseth [[link removed]] and Vice President J.D. Vance [[link removed]] . Policymakers are now confronted with a critical question, one that also arose [[link removed]] during President Donald Trump’s first term: Should the Department of Veterans Affairs remain the direct provider of care, or should there be a move toward outsourcing health services to the private sector?
On one side: Veterans Affairs Secretary Doug Collins has overseen unprecedented staff reductions [[link removed]] in VA health centers across the nation and worked to expand the use [[link removed]] of private providers. Collins argues that “money and people do not solve the problems,” even as demand for veterans’ health care continues to outpace the department’s capacity to provide it [[link removed]] .
But opponents warn that this process could gut the VA system [[link removed]] , which consistently ranks as well as or better [[link removed]] than comparable private facilities. Over 9 million veterans [[link removed](VHA,the%20VA%20health%20care%20program.] receive all their care within the VA, often involving highly specialized treatments. By shifting them to a fragmented [[link removed]] and costlier for-profit system, massive gaps in care can emerge.
Sensing a potential shift under the Trump administration, private health care companies and industry associations have focused their political spending on veterans’ care policy.
Follow the money
The push to privatize veterans’ health care has piqued the interest of members of the VA’s Community Care Network, companies that provide health services when the VA cannot.
One of these companies is UnitedHealth Group, where employees and PACs affiliated with the Optum Serve division donated [[link removed]] $125,410 to the members of the House and Senate committees overseeing veterans’ affairs during the 2024 election cycle. They also donated $221,082 to the House and Senate Armed Services committees. Additionally, UnitedHealth was one of many in the health sector that lobbied against the 2024 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act [[link removed]] , which includes new parity-of-care standards [[link removed]] .
Other major health care organizations [[link removed]] lobbying on the bill included Blue Cross Blue Shield, the American Hospital Association and the American Medical Association. The bill ultimately passed in March 2024, and directs more funding to private providers while expanding the capabilities of non-VA entities in veterans’ health care.
Another group involved in the VA’s Community Care Network is TriWest Healthcare Alliance, which connects veterans to community-based health services. TriWest spent $190,000 on lobbying in the first three quarters of 2025, putting the company on track for its largest spending year since 2021. (TriWest’s biggest lobbying expenditure [[link removed]] occurred in 2019, reaching nearly $800,000; this was soon after enactment of the VA MISSION Act, which dramatically expanded veteran community care services.)
Members of the House Veterans’ Affairs Committee received nearly $4.5 million in contributions [[link removed]] from the health sector: $2.2 million from political action committees, and another $2.2 million from individuals. Among the top donors [[link removed]] was the American Optometric Association. Health professionals also ranked seventh [[link removed]] among the top industries contributing to the committee in the 2024 election cycle, donating a total of $2.4 million, with 60 percent going to Republicans.
The Senate Veterans’ Affairs Committee received similarly large totals [[link removed]] in the 2024 election cycle: $6.9 million from health sector political action committees, and another $16.8 million from individuals. Health professionals ranked sixth [[link removed]] among top industries donating to the Senate committee, contributing a total of $11.9 million.
The American Legion [[link removed]] , one of the nation’s largest veterans interest groups, strongly opposes the privatization of veterans’ health care. Since 2022, its lobbying spending has surged [[link removed]] , reaching $760,000 in 2023 and 2024, with 2025 projected to hit the same level. Paralyzed Veterans of America [[link removed]] , another prominent veterans interest organization, spent $265,065 on lobbying and has actively engaged on multiple bills [[link removed]] related to the privatization of veterans’ care, including the Veterans Health Care Freedom Act and legislation amending external provider scheduling programs.
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Chart of the week
China and Japan spend big on K Street
Just about any country you can think of has interests in the United States, ranging from policy concerns to tourism and trade promotion. Many governments, companies and other entities pay foreign agents to influence U.S. policy and opinion in pursuit of those interests.
From 2016 to 2024, China and Japan together paid almost $1 billion in lobbying fees. Seven of the top 10 countries are located in the Far East or Middle East.
Bar chart showing total contributions by members of the Marines, by part of recipients, by election cycle since 2000 [[link removed]]
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What else we're reading
Supreme Court weighs campaign finance limits in GOP-backed challenge [[link removed]] (CBS News)
Why Wisconsin Supreme Court elections are so expensive [[link removed]] (PBS Wisconsin)
New data visualization shows out-of-state lobbying money flowing into Idaho [[link removed]] (Idaho Capital Sun )
New dark money network could exploit campaign finance loophole banning federal contractors from spending on politics [[link removed]] (Washington Examiner)
OpenSecrets in the News
See our media citations from outlets around the nation this week:
Divided US Supreme Court grapples with campaign spending curbs in JD Vance case [[link removed]] (Reuters)
The 2024 presidential campaign of Trump's Democratic rival Kamala Harris, for example, raised about $460 million from donors who made annual contributions below $200, compared to Trump's roughly $130 million haul from small donors, according to OpenSecrets, a nonpartisan campaign finance watchdog.
Thomas Massie, facing Trump’s opposition, gets a hand from billionaire megadonor [[link removed]] (Kentucky Lantern)
Politically conservative with a libertarian streak, Yass has backed Kentucky U.S. Sen. Rand Paul since Paul’s failed bid for the 2016 Republican nomination for president. And, according to the campaign finance watchdog group OpenSecrets, Yass has made more than $100 million in contributions to super PACs in the 2023-24 election cycle.
Who Are Michael And Susan Dell? What We Know About The Latest MAGA Celeb Wannabes [[link removed]] (The List)
Meanwhile, OpenSecrets records confirmed that although Michael had also donated to Democrats, the overwhelming majority of his money had been given to conservative politicians. With the Dell founder's reported donations, he showed support to the likes of Ted Cruz, Mitch McConnell, and Former President George W. Bush, among many others.
What to know about the air traffic control overhaul and the company FAA hired to manage it [[link removed]] (The Associated Press)
The company’s political action committee donated a quarter-million dollars to politicians last year with a little over half of that going to Republicans, according to www.opensecrets.org.
Health care lobbying surged in 2025 [[link removed]] (Crain's New York Business)
Health care lobbying expenditures spiked 16% to $653 million during the first three quarters of 2025 compared with the same period a year before, according to a Modern Healthcare analysis of data compiled by OpenSecrets, which tracks campaign finance and lobbying spending. Two metro area pharmaceutical companies – Hudson Yards-based Pfizer and Rahway, N.J.-based Merck – were near the top of the list of prolific health care lobbying interests.
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