Health interests aggressively vied for the state’s attention over several high-profile issues and spent tens of millions of dollars on lobbyists to get it.
Companies and wealthy individuals spent a record $377 million to directly influence state government in 2024, just shy of a 5% increase over the year before, according to records kept by the state’s ethics board. Four of the top six lobbying spenders in the state last year were health companies pushing for or against several of the policy issues dominating the last legislative session: an overhaul of a popular home care program, the rescue of a beleaguered safety net hospital and a host of hospital interests.
Topping the list was 1199SEIU, the state’s largest health care union, which spent close to $11.5 million on lobbyists in New York. The union is a regular on the annual top ten lobbying list, kept by the Commission on Ethics and Lobbying in Government, but this year it increased its spending by 28%, largely to back the controversial push to move the state’s consumer directed personal assistance program – a nearly $12 billion Medicaid program that allows clients to hire and manage their own caretaker – to a single broker.
That transition, which lawmakers approved in the state budget last year to reduce what Gov. Kathy Hochul called rampant fraud, has the potential to bring hundreds of thousands of home care workers into the union. But it was fiercely opposed by the hundreds of companies administering the payroll and paperwork for aides serving roughly 280,000 recipients, for whom the transition is viewed as an existential threat. The Alliance to Protect Home Care, the group representing the existing companies, spent $10.6 million on lobbyists in Albany, the second biggest spender in the state behind 1199. The group, a first-timer on the state’s top-ten list, lost the legislative battle last year, but continues to push for a reversal of the decision and has backed lawsuits to slow the transition down.
Greater New York Hospital Association, the region’s powerful hospital trade group and a perennial big spender, was again in the ring last year, spending $3 million to advance positions on a myriad of issues. The trade group, which represents roughly 280 hospitals and health systems in the northeast, was the fourth biggest lobbying client, seeking favor with the governor and state lawmakers on Medicaid funding, wrongful death legislation and other bills, according to records kept by the state.
The year before, 1199 also took the top slot with GNYHA a few spaces behind, but no group spent above $10 million, and the top six included a more diverse group of housing and education interests. In 2024 as in 2023, Genting New York, the owner of Resorts World Casino, which is seeking one of 3 coveted downstate casino licenses, made the list, and last year Queens Future, the limited liability company pushing billionaire Steve Cohen’s bid to get a casino on the parking lot next to Citi Field, ranked number five in lobbying spending.
The impending closure of SUNY Downstate Medical Center, a financially distressed public hospital in Flatbush, drew heavy opposition from a range of state and local leaders, including the United University Professions, the union representing SUNY faculty and professional staff. The union spent over $2 million on lobbyists to push a rescue plan for the hospital, one of three run by SUNY and part of a thinning network of facilities serving low-income parts of central Brooklyn.
The spending made it the sixth biggest lobbying client in the state. Ultimately, lawmakers bailed out Downstate with an infusion of operating funds. The union is now backing a nearly $1 billion plan to refurbish the hospital that was developed by a state-appointed panel earlier this year.
