BEACON HILL’S MOST POWERFUL lobbying shops continued to rake in cash at a growing rate this year from clients who want to sway policymakers on everything from sports betting to internet connectivity to, most frequently, health care.
Continuing a long-running trend, many of the companies, industry groups, and other clients that spent the most on lobbying services between January and June work in health care or related fields such as pharmaceuticals.
The Massachusetts Health and Hospital Association, which represents hospitals and providers, and the Massachusetts Association of Health Plans, which represents insurers, were the only two clients that spent more than half a million dollars each to influence state government in the first half of the year, according to data released this week by Secretary of State William Galvin’s office.
MHA jumped into the top-spending spot this year with $577,789, flipping places with MAHP, which spent $550,065. In the same six-month span last year, MAHP ranked first with $616,981 spent and MHA second with $558,312 spent.
“As the challenges of the Commonwealth’s biggest sector intensify, we are privileged to provide our elected officials with a united voice for the hospitals and health systems who rely on smart public policy to innovate, maintain care services, and meet the daily needs of patients,” said MHA spokesperson Sam Melnick.
Lora Pellegrini, CEO of the group representing health insurance plans, said her group has been in regular communication with Beacon Hill this year “to evaluate the impact of proposed federal funding cuts that could disrupt coverage for Massachusetts residents starting in 2026.”
Pellegrini, herself a registered lobbyist who earned more than $247,000 from MAHP in the first six months of the year, said the organization also worked with the Healey administration to implement new hospital oversight and prescription drug cost control laws.
“In addition, as new health care legislation was introduced during the first half of the year, MAHP participated in public hearings to share data and perspectives, helping lawmakers understand how proposals would affect affordability and access for patients and employers across the Commonwealth,” she said.
The next two positions in the rankings also went to health care-related groups: the Massachusetts Biotechnology Council spent $343,030, followed by the Association for Behavioral Healthcare, which spent $282,777 in a ramp-up of its lobbying activity. The organization spent $203,709 – nearly $80,000 less – over the same period last year.
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Several other major industry players also figure toward the top of the list, including the Massachusetts Nurses Association (ninth overall with $222,310 spent on lobbying), Beth Israel Lahey Health (11th, with $209,000 spent) and Mass General Brigham (12th, with $207,642 spent).
Health care is a key economic driver for Massachusetts — forming half of the “eds and meds” catchphrase often deployed to describe the state’s biggest strengths — and it’s also an industry facing significant upheaval. Costs continue to grow at rates exceeding inflation, many providers are struggling with workforce issues, and patients face geographic disparities accessing care.
After lawmakers and Gov. Maura Healey implemented a new hospital oversight law and prescription drug cost controls at the start of the year, more action could be on the horizon.
Top House and Senate Democrats are moving this week to provide hospitals and community health centers with a $234 million funding injection, but they have not yet outlined any concrete plans for other legislation.
A couple of other familiar names appear in the list of top-spending lobbyist clients through the first half of this year. The Massachusetts Teachers Association spent about $257,000 on lobbying between January and June, fifth-most of any client, as it works to influence debate about a new, post-MCAS graduation standard and takes early steps toward supporting a new wealth tax that would fund debt-free public college.
Keolis Commuter Services, which is hoping to win another bid to continue operating the MBTA’s commuter rail after the current contract expires in 2027, ranked eighth with $225,000 spent on lobbying.
The list of firms who earned the most in the first half of 2025 remained mostly unchanged, led by the same top three: Smith, Costello and Crawford, Tremont Strategies Group, and O’Neill and Associates. Most of the other big names retained their positions close to the top, with a handful moving up or down the rankings.
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Each of the five highest-earning entities hauled in more between January and June than they did in the same span last year, with especially large jumps for Tremont (17.4 percent increase), Dempsey Associates (25 percent increase) and Smith, Costello and Crawford (28.3 percent increase).
Some of that growth has been driven by new clients joining the scene. Smith, Costello and Crawford collected $120,000 — the largest single payment to the firm this year — from HG Vora Capital Management, a New York company that for the first time sought lobbying on “issues related to the regulation of the gaming industry.”
Another gambling-related organization, the Sports Betting Alliance, increased its spending with Smith, Costello and Crawford from $15,000 in the first half of 2024 to $90,000 in the first half of 2025.
Many lawmakers land lobbying gigs after they depart the House and Senate, or outright trade public office for the private sector, and data continue to show they can earn far more working to sway the Legislature from the outside than they do from the inside.
House Speaker Ron Mariano and Senate President Karen Spilka were tied for the highest-paid lawmaker, each with $203,286 in total pay in all of 2024. Twenty-three different registered lobbyists collected more than that amount just in the first half of 2025.
Former rep. Carlo Basile and former Senate president Robert Travaglini more than doubled the 2024 full-year top legislative paycheck in the first six months of this year, earning $425,000 and $412,000, respectively.
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