Healthcare executives have a clear favorite for the White House, and it's not the person who gave them a big tax cut three years ago.
America's top healthcare bosses are pouring cash into Democratic candidate Joe Biden's campaign and the outside groups supporting him, an Insider analysis of Federal Election Commission records and data compiled by the Center for Responsive Politics shows.
Insider reviewed the campaign-spending records for executives at 100 major healthcare companies this election cycle, including drugmakers, insurers, health-tech companies, and hospitals.
The Biden campaign has raised almost $47 million in personal donations from healthcare executives over the course of the 2020 cycle, while President Donald Trump's campaign has brought in $21 million, according to the Center for Responsive Politics, which runs the money-in-politics website Open Secrets.
That does not include donations coming in through super PACs, the political-action committees allowed to raise unlimited amounts of money from people and companies.
When combined with money from super PACs, Trump's numbers are inflated by donations from one main donor: Miriam Adelson, who runs a drug-rehabilitation clinic in Las Vegas and is the wife of GOP mega-donor Sheldon Adelson.
The money going to Biden has come from CEOs, vice presidents, and other C-suite executives, from companies that include Kaiser Permanente, Merck & Co., McKesson Corp., and Independence Blue Cross. Some of the executives donating to Biden are from companies at the forefront of the coronavirus-vaccine creation being pushed by Trump, such as Moderna.
The industry's preference for Biden over Trump is surprising considering the Republican president's business-friendly positions and the tax cuts he signed into law in 2017 that gave corporations a huge windfall.
But Trump's executive actions to lower drug prices have not made him many friends in the industry. Those policies would take years to implement, and could be tied up in lawsuits from drug companies.
Biden, on the other hand, has promised, if elected, to reduce health-insurance prices and cut the cost of prescription drugs. He would also raise taxes on rich people and corporations. And he has vowed to preserve and strengthen former President Barack Obama's Affordable Care Act that the healthcare industry supports and Trump is seeking to strike down.
Biden is leading in the polls, and Democrats are within range of both winning control of the Senate and retaining their House majority.
If Democrats win big, healthcare executives want in, and they're "hedging bets" ahead of a likely new administration, Bruce Freed, the president and cofounder of the nonpartisan Center for Political Accountability, said.
"These folks want to be giving beforehand so that they can sort of have a foot in the door," Freed told Insider.
The Trump campaign cast the donations to Biden as a sign that the Democratic candidate is too cozy with the pharmaceutical industry.
"Joe Biden says he wants to bring down drug costs, but the Obama-Biden administration caved to drug makers during Obamacare negotiations, and based on the Big Pharma executives' donations to the Biden-Harris ticket, they feel confident he would cave to them again," Trump campaign spokeswoman Courtney Parella told Insider.
The executives gave within the legal maximum for a federal candidate — $2,800 — and made larger donations through super PACs.
"Some of these could be personally driven," Freed said. "I think some of them also are business-driven in terms of showing support, building relationships, even if it's a smaller amount. Clearly the fact that it's public, it sends a message."
Among the biggest donors is Kenneth Frazier, the CEO of pharmaceutical giant Merck. He's given $50,000 to the Biden Victory Fund, a joint fundraising effort between Biden's campaign and the Democratic National Committee. Frazier also gave the $2,800 maximum contribution directly to the Biden campaign.
Daniel Hilferty, the CEO of insurer Independence Blue Cross, donated $30,000 to Biden Victory Fund and contributed $2,800 to the Biden campaign.
Applied Medical Resources Corp.'s CEO, Said Hilal, gave the Biden campaign $5,000 this year, according to the company, which said the FEC listing showing a higher donation of $11,000 was incorrect.
Kaiser Permanente CEO Gregory Adams donated $2,800 directly to Biden's campaign and $5,600 to the Biden Victory Fund in May. A spokesperson said Kaiser Permanente doesn't make political contributions because it's a tax-exempt nonprofit, but that its employees aren't precluded from doing so.
"Kaiser Permanente employees and physicians are free to engage in political activity on their own, if they choose to do so," the spokesperson told Insider.
Lower-level executives are chipping in too. Mary Moreland, executive vice president for human resources at the health-devices company Abbott Laboratories, donated $5,600. The company created the rapid turnaround coronavirus tests that the White House has been using for routine checks on Trump, staffers, and guests.
Two executives at McKesson, which will be distributing the coronavirus vaccine once it's available, also made personal donations to Biden. Lori Schechter, executive vice president and chief legal officer, donated $8,400. Robin Jacobsohn, the company's senior vice president and associate general counsel, gave $3,800.
Insider also found about 30 other executives who gave within the maximum allowed donation of $2,800 for federal candidates. They include Brian Sandstrom, vice president and associate general counsel at Moderna, which is developing a coronavirus vaccine; Susan Alexander, executive vice president at biotech giant Biogen Inc.; Anil Soni, head of global infectious diseases at Mylan Inc., and Michael Putnam, senior vice president for consumer markets at Amwell, one of the US's largest telemedicine companies.
Most representatives for the companies either didn't respond or declined to comment.
Centene's big bet
One noticeably large set of contributions to the Biden campaign and House Democrats came from Centene Corp., a health insurer that mainly focuses on partnering with the government to cover people who earn low incomes.
The company was one of the biggest beneficiaries of the Affordable Care Act thanks to millions of newly insured people whose coverage was subsidized by the government. Biden helped create the healthcare law and wants to make sure it's improved rather than gutted, as Trump would prefer.
At least five Centene executives have made maximum donations directly to Biden's campaign since May, records show. They include Jeffrey Schwaneke, the company's executive vice president, CFO, and treasurer; Thomas Irwin, a senior vice president; and executive vice president Brandy Burkhalter.
The Biden campaign lists Centene's president and CEO Michael Neidorff among people who have helped raise more than $25,000 for the Democrat's election effort.
Neidorff has personally given separate donations — each of $35,500 — to elect both House Democrats and Senate Republicans. But there's no indication he's given to Trump.
The Biden campaign, which has made the 2020 election largely about healthcare, declined to comment on the donations pouring in from healthcare executives.
'Executives in business like certainty'
When super PAC money is included, Trump at first glance appears to be a favorite of the health sector. But his numbers are skewed by a huge haul tied to a single GOP mega-donor. All together, Biden's campaign and pro-Biden groups have brought in $54 million from health-industry donors compared with the $60 million Trump's reelection effort has received from individuals and super PACs.
Sarah Bryner, the director of research and strategy at the Center for Responsive Politics, attributes the difference to a $37.5 million donation to pro-Trump super PAC Preserve America from Miriam Adelson of the Las Vegas-based Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research Inc.
Insider reported in June that healthcare executives were passing up donations to Trump but that several had given to down-ballot Republicans, including House Minority Leader Kevin McCarthy of California. Since then, as Election Day has drawn nearer and Biden has consistently held the lead in most polls, the Democratic candidate has picked up more donations from the industry's leaders.
In other recent elections with an incumbent running, healthcare donations have favored Republicans. Mitt Romney hauled in $19.5 million in the 2012 cycle, slightly beating incumbent Obama's $19.2 million from the healthcare sector. President George W. Bush received $11.2 million for his 2004 reelection, topping the $7.9 million his Democratic rival John Kerry took in.
Freed said he suspected that executives, when considering their donations, were thinking not just about how Trump conducts himself in office — "the rawness, the attacks, the atmosphere" — but also about broader issues that the country faces, notably the coronavirus crisis and racial injustice.
"Executives in business like certainty," Freed said. "And the fact is there has been a great deal of uncertainty and instability."
Trump loses out to down-ballot Republicans
It isn't to say that healthcare executives have ignored Republicans altogether this election season.
According to campaign-finance records, Robert Bradway, the CEO of biopharmaceutical company Amgen Inc., has since June given $25,000 to the National Republican Congressional Committee, which supports House races.
Grant Verstandig, the chief digital officer at Optum, gave $46,740 to the Republican National Committee. Optum is a leading health-services company owned by UnitedHealth Group, the nation's largest insurer. Verstandig originally came to his role after founding digital health company Rally Health, which Optum now owns.
But Freed cautioned against comparing Trump to other Republicans, saying that business leaders have faced backlash for supporting the president, who openly lashes out at companies and individuals.
"There might be a sense that even if they disagree with the Democrats and with Biden on policy," Freed said, "I think they would say that it would return sort of a more normal environment in terms of how things are dealt with."