Lobbying Infrastructure
Federal expenditures · Retained firms · The revolving door · Dark money
FAH has spent between $2.2 million and $3.7 million annually on federal lobbying every year since 2010.
| Year | Amount |
|---|---|
| 2025 (partial) | $3,565,000 |
| 2024 | $2,380,000 |
| 2023 | $2,523,000 |
| 2022 | $2,800,000 |
| 2021 | $2,440,000 |
| 2020 | $2,590,000 |
| 2019 | $3,570,000 |
| 2018 | $2,610,000 |
| 2017 | $3,740,000 |
| 2016 | $2,770,000 |
| 2015 | $2,700,000 |
| 2014 | $3,360,000 |
| 2013 | $3,270,000 |
| 2012 | $2,350,000 |
| 2011 | $2,400,000 |
| 2010 | $2,640,000 |
FAH retains six external lobbying firms with combined 2025 contracts of $1.42 million, staffed primarily by former congressional and executive branch officials.
| Firm | 2025 Contract | Key Access |
|---|---|---|
| Miller Strategies | $540,000 | Republican outreach |
| Avoq LLC | $240,000 | Public affairs, communications |
| Marshall & Popp | $240,000 | Senate Majority Leader (McConnell alumni), Senate Majority Whip (Cornyn alumni) |
| Welsh Rose LLC | $200,000 | Health policy, regulatory affairs |
| Cozen O’Connor | $160,000 | Legal and regulatory advocacy |
| Capitol Tax Partners | $40,000 | Tax policy, hospital finance |
83% of FAH’s registered lobbyists in 2024 previously held government positions — significantly above the 61% sector average.
| Name | FAH Role | Prior Government Position |
|---|---|---|
| Charlene MacDonald | President and CEO (2026) | Senior policy advisor to House Minority Whip Steny Hoyer; senior policy advisor, Senate Budget Committee |
| Charles N. Kahn III | President and CEO (2001–2025) | Staff Director, House Ways and Means Health Subcommittee (1986–1993, 1995–1998); Legislative assistant, Sen. Dan Quayle; Senior health policy advisor, Sen. David Durenberger, Senate Finance Committee; Campaign manager, Newt Gingrich (1974–1976) |
| Rebecca Heilig Lira | SVP, Government Relations | Associate Director, White House Office of Public Liaison (Trump administration); Deputy Director of Member Services, RNC |
| Hazen Marshall | Marshall & Popp | Policy Director, Senate Majority Leader Mitch McConnell |
| Monica Popp | Marshall & Popp | Chief of Staff, Senate Majority Whip John Cornyn |
| David Castagnetti | Mehlman Castagnetti | Chief of Staff, Sen. Max Baucus (D-MT), Chair Senate Finance Committee |
| Dean Rosen | Mehlman Castagnetti | Chief healthcare adviser, Senate Majority Leader Bill Frist (R-TN) |
| Thomas Scully | Alston and Bird | Former Administrator, CMS under President George W. Bush |
| Colette Desmarais | Mehlman Castagnetti | Top health policy aide, Sen. Charles Grassley (R-IA), Chair Senate Finance Committee |
Charles N. Kahn III completed a rare double pass through the revolving door — congressional staff to industry, back to congressional staff, back to industry — each transition deepening his policy influence.
| Period | Role | Organization |
|---|---|---|
| 1974–1976 | Campaign manager | Newt Gingrich congressional campaigns |
| Early 1980s | Legislative assistant for health | Office of Sen. Dan Quayle (R-IN) |
| ~1984–1986 | Senior health policy advisor | Office of Sen. David Durenberger (R-MN), Senate Finance Committee |
| 1986–1993 | Minority health counsel, Health Subcommittee | House Ways and Means Committee |
| 1993–1995 | Executive VP (ran Harry and Louise campaign) | Health Insurance Association of America |
| 1995–1998 | Staff Director, Health Subcommittee | House Ways and Means Committee |
| 1998–2001 | President and CEO | HIAA |
| 2001–2025 | President and CEO | Federation of American Hospitals |
Charlene MacDonald became FAH President and CEO on January 1, 2026, succeeding Chip Kahn after nearly 25 years.
| Detail | Value |
|---|---|
| Current role | President and CEO, FAH (effective January 1, 2026) |
| Prior FAH role | Executive Vice President of Public Affairs (2023–2025) |
| Prior government role | Senior policy advisor to House Minority Whip Steny Hoyer; senior policy advisor, Senate Budget Committee |
| Prior private sector | Chief Government Affairs Officer, CareFirst BlueCross BlueShield |
FAH co-founded the Partnership for America’s Health Care Future in 2018 — a 501(c)(4) dark money coalition that spent over $143 million opposing Medicare for All and public option proposals.
| Detail | Value |
|---|---|
| Founded | June 2018 |
| Type | 501(c)(4) — donors not publicly disclosed |
| Initiated by | Chip Kahn, FAH President and CEO |
| Founding members | FAH, AHIP, PhRMA |
| Expanded to include | AHA, Blue Cross Blue Shield Association (grew to 124 members) |
| Name | Intentionally nondescript to obscure industry membership |
| Activity | $143M+ combined industry spending opposing Medicare for All; $200,000+ TV ads August 2019 alone; extensive digital advertising |
“A coalition was quickly assembled, initiated by Chip Kahn, President and CEO of the Federation of American Hospitals, in an effort to stop UHC proposals progressing from campaign platforms to items on legislative agendas.”
— Peer-reviewed study, PubMed Central