The health insurance industry is donating big to Democrats even amid criticism of the industry and growing calls for “Medicare for All” from the progressive wing of the party.

Four big insurance companies — Blue Cross Blue Shield, UnitedHealth Group, CVS Health and Cigna — and their employees have given about $4.5 million collectively in campaign contributions in the 2020 cycle, according to the Center for Responsive Politics.

Just more than half — about $2.3 million — of that has gone to Democrats, including to some of the party’s top-tier presidential contenders. The Center for Responsive Politics totals are based on Federal Election Commission data through the third quarter of 2019 and include money from the companies and their PACs, owners and employees and their immediate families. These companies and employees have been giving big, on both sides, in recent cycles.

ADVERTISEMENT

Historically the industry has given to both sides of the aisle, but the contributions to Democrats are a troubling issue for some progressives and health advocates, who want the party to do more to rein in private insurers and reform the health care market. They worry the contributions will make it harder for Democrats to take a tougher line on insurers despite calls for change.

“Insurance companies are using their money to try and influence not only Republicans but Democrats as well. The problem is that they control the whole system,” Paco Fabian, director of campaigns at the progressive group Our Revolution, told The Hill.

“They’re influencing both sides and they’re doing it so that regardless of who wins, they continue to influence politics and policy.”

Health care reform and the role of insurers has become the center of a fierce fight in the 2020 Democratic primary, with Sen. Bernie Sanders Bernie SandersKenosha will be a good bellwether in 2020 Biden's fiscal program: What is the likely market impact? McConnell accuses Democrats of sowing division by 'downplaying progress' on election security MORE (I-Vt.) pushing his signature Medicare for All proposal that would get rid of private insurers. Former Vice President Joe Biden Joe BidenSenate Republicans face tough decision on replacing Ginsburg What Senate Republicans have said about election-year Supreme Court vacancies Biden says Ginsburg successor should be picked by candidate who wins on Nov. 3 MORE, though, has criticized Sanders as well as Sen. Elizabeth Warren Elizabeth WarrenBiden's fiscal program: What is the likely market impact? Warren, Schumer introduce plan for next president to cancel ,000 in student debt The Hill's 12:30 Report - Presented by Facebook - Don't expect a government check anytime soon MORE (D-Mass.), who favors a more measured transition to Medicare for All by first passing legislation for optional government health insurance.

Biden has sharply attacked Medicare for All, saying it would be too costly and unrealistic. Biden and former South Bend, Ind., Mayor Peter Buttigieg (D) have instead pushed plans that give people the option of a government-run health plan without making coverage mandatory.

Sanders last year even urged fellow candidates to reject contributions from the health industry, including insurers.

ADVERTISEMENT

But the center’s numbers show the top-tier candidates having received contributions from companies and employees.

Blue Cross Blue Shield and its employees, for example, have given more than $24,000 each to Biden, Buttigieg and Sanders and more than $16,000 to Warren, according to the center’s numbers. President Trump Donald John TrumpObama calls on Senate not to fill Ginsburg's vacancy until after election Planned Parenthood: 'The fate of our rights' depends on Ginsburg replacement Progressive group to spend M in ad campaign on Supreme Court vacancy MORE received more than $4,000.

UnitedHealth Group and its employees have given more than $25,000 to Sanders, nearly $20,000 to Biden, nearly $15,000 to Buttigieg, nearly $14,000 to Warren and more than $6,000 to Trump.

Cigna and its employees gave more than $8,000 to Buttigieg, $7,500 to Biden, more than $7,000 to Sanders, $5,500 to Warren and more than 3,300 to Trump.

And CVS Health and its employees have given $33,000 to Sanders, $20,000 to Buttigieg, about $12,000 to Warren, more than $9,000 to Biden and $5,000 to Trump.

The Biden campaign denied a request for comment, and Warren’s and Sanders’s campaigns did not respond to The Hill’s request.

“We are proud to have the support of more than 730,000 Americans who have already donated to our campaign and the only promise any donor will ever get from Pete is that he will use their donations to defeat Donald Trump,” Buttigieg’s campaign said in a statement, adding that the candidate’s “Medicare for all who want it” plan would “enact some of the boldest, most progressive changes.”

Overall, the industry’s contributions highlight its strength — and influence — with both parties.

“Insurance companies and their employees understand that hedging their bets and giving money to both Republicans and Democrats is a smart way to stop any kind of health care reform, including, but not limited to, Medicare for All,” Lisa Gilbert, vice president of legislative affairs at Public Citizen, told The Hill.

“Insurers are so monied that they can outspend proponents exponentially, so there is no reason to choose sides.”

Blue Cross Blue Shield and its employees have donated nearly $2 million so far in the 2020 cycle, and 54 percent of that has gone to Democrats, according to Center for Responsive Politics numbers.

UnitedHealth Group and its employees have donated nearly $1.3 million in the current cycle, with 54 percent going to Republicans.

ADVERTISEMENT

Cigna and its employees, meanwhile, have contributed only $625,000 so far — with 52 percent to Republicans and 47 percent to Democrats. And CVS Health and its employees have donated only about $610,000 so far, with 56 percent of that going to Democrats.

“We make donations across the political spectrum and to elected officials from both major parties. Donations are by no means a blanket endorsement of an elected official’s position on every issue,” a spokesman from CVS Health told The Hill.

Cigna told The Hill it had no comment, and Blue Cross Blue Shield as well as UnitedHealth Group did not respond to The Hill’s request for comment.

Others noted that the insurance industry does not have a notably partisan workforce, unlike the technology industry whose workforce tends to embrace many liberal causes and is often found in blue states.

Margarida Jorge, executive director of the Lower Drug Prices Now coalition, noted that employers of insurance companies don’t necessarily oppose Medicare for All.

“A lot of people who are working in the health insurance industry and in health care at large actually have really progressive stances on health care and want to see less profit in the system,” she said. “Just because someone works for an insurance company doesn’t mean they share the political ideology of the company.”

ADVERTISEMENT

Still, watchdog groups say those contributions will make it harder for Washington to enact health care reform, regardless of the 2020 outcome.

“For years, the status quo of industry has been to line the pockets of elected on both sides of the aisle,” said Kelly Coogan-Gehr, assistant director of public and community advocacy at National Nurses United, a union that represents nurses.

“Over the past year, we have seen an increasingly aggressive effort on the part of the insurance industry and the health care industry in general to consolidate and to get organized around fighting Medicare For All.”