Some of the most influential aides in Sen. Max Baucus's closed-door Senate Finance Committee negotiations over health care reform have ties to interests that would be directly affected by the legislation. Revolving door for health care aides

Some of the most influential aides in the closed-door Senate Finance Committee negotiations over health care reform have ties to interests that would be directly affected by the legislation.

Before she was hired last year as senior counsel to Finance Committee Chairman Max Baucus (D-Mont.), Liz Fowler worked as a highly paid public policy adviser for WellPoint Inc., the nation’s largest publicly traded health benefits company.


Mark Hayes, health policy director and chief health counsel for Finance Committee ranking member Chuck Grassley (R-Iowa), is married to a registered lobbyist for a firm that represents drug companies and hospital groups, although the couple says she doesn’t lobby Grassley’s office.

Frederick Isasi, a health policy adviser to Sen. Jeff Bingaman (D-N.M.), was a registered lobbyist at Powell Goldstein, where his clients included public hospitals and the American Stroke Association.

Kate Spaziani, senior health policy aide to Sen. Kent Conrad (D-N.D.), was also a registered lobbyist at Powell Goldstein, although Conrad’s office says she worked as a lawyer — not as a lobbyist — for public hospitals on Medicare issues.

There’s no evidence that the aides’ ties have shaped the bill that Baucus hopes to release Tuesday, and the ultimate decisions over its provisions rest with the senators themselves. But critics say the involvement of such well-connected insiders could lead to dangerous conflicts.

“It raises the concerns about the revolving door that have always been present,” said Sheila Krumholz, executive director of the Center for Responsive Politics, a group that tracks influence in politics. “This just brings it into the fore because it’s such a far-reaching bill.”

The revolving door swings both ways in the health care debate — and the Finance Committee isn’t the only place where it stops.

All across Capitol Hill, a number of former lobbyists, consultants and advisers for firms that represent consumers, patients, hospitals, insurers, pharmaceutical companies and medical device makers are now in key positions in the House and Senate, according to a review of public records.

Mark Childress, a senior attorney on the Senate Health, Education, Labor and Pensions Committee who was a high-level official in the Clinton White House and an aide to former Sen. Tom Daschle (D-S.D.), was a partner at the law firm Foley Hoag, working in the government-relations department there before joining the HELP staff last spring.

Kathleen Kerrigan was a tax lobbyist at the firm Baker & Hostetler until February 2005 and is now advising Sen. John Kerry (D-Mass.) on the tax issues in the debates over health care and other matters.

And according to the group Public Accountability Initiative, which tracks politicians’ ties to various interests, more than 500 former congressional aides have gone on to become health care lobbyists.

Both lobbyists-turned-aides and aides-turned-lobbyists say they offer unique expertise and experience as lawmakers try to rewrite the nation’s health care laws.

“It gave me a very different perspective, leaving the Hill,” said Debbie Curtis, who spent two years as a lobbyist for the consumer advocacy group Consumer Action during the Clinton-era health care debate. Curtis is currently the chief of staff for Rep. Pete Stark (D-Calif.), the chairman of the powerful health subcommittee on the House Ways and Means Committee.

Asked if the revolving door creates a problem, David Wenhold, president of the American League of Lobbyists, said, “Absolutely not,” adding that “most lobbyists are subject-matter experts in their areas.”

Indeed, Fowler — by several accounts the most important aide in the Gang of Six negotiations — is a seasoned veteran who has worked in a variety of areas in the health policy field.

“Liz Fowler is a smart and talented individual and one of the brightest health care minds in the Senate, and she and the Finance Committee staff have been working day and night to help achieve this goal” of crafting a health care bill to lower costs and provide affordable coverage, said Scott Mulhauser, spokesman for Baucus. “Sen. Baucus has served in the Senate for more than 30 years, and the only factor that influences his decisions and the decisions of his staff is whether a policy is right for his state and for the American people. Period.”

But when Baucus’s office announced in early 2008 that it was hiring Fowler, it didn’t exactly advertise that she’d been on the payroll of a massive health benefits firm. Baucus’s press release cited Fowler’s prior experience in his office and on the staff of the late Sen. Daniel Patrick Moynihan (D-N.Y.) as well as her work for a private law firm. It didn’t mention her most recent work for WellPoint, where she was not a registered lobbyist but served as an adviser.

WellPoint spokeswoman Cheryl Leamon said that the company does not “see it as an advantage” to have Fowler participating in the Gang of Six negotiations.

“It’s not unusual for a policy expert to go back and forth between the public and private sectors,” she said.

Hayes — the Grassley aide whose wife represents the American Board of Internal Medicine and other clients as a lobbyist for Jennings Policy Strategies — said he and his lobbyist wife have taken steps to prevent any possible conflicts of interest. Katherine Hayes, a onetime Senate aide, does not contact Grassley’s staff while working on behalf of her clients.

“As far as health care policy generally, there’s not much we agree on, so we don’t even like talking about it,” Mark Hayes said.