Over the summer, Under the Influence profiled the 25 top-spending health care players by total lobbying expenditures for the first half of the year. On the chart below, see how much those groups dished out from July through September. Lobbying numbers reflect total lobbying activities for a given organization, and several organizations are also involved in non-health care related issues.
Several groups significantly increased lobbying spending in the third quarter over the second quarter: the Chamber of Commerce, America's Health Insurance Plans, American Cancer Society Cancer Action Network, American Academy of Family Physicians and the Alliance for Quality Nursing Home Care.
Lobbying spending often fluctuates from quarter to quarter, but this year's third quarter still topped previous years. The Chamber of Commerce, for example, spent $34.7 million in the third quarter of 2009, compared with $20.6 million in the third quarter of 2008.
Not all groups upped the ante, however: Business Roundtable, for example, spent $1.9 million in the third quarter of 2009, compared with $6.1 million in the second quarter of 2009 and $2.1 million in the third quarter of 2008.
| Group | Lobbying Spending, Q1 & Q2 | Q3 Spending | Total | |
| 1. Chamber of Commerce | $17,426,000 | 34,690,000 | 52,116,000 | |
| 2. PhRMA | 13,060,000 | 6,790,000 | 19,850,000 | |
| 3. AARP | 9380000 | 5,680,000 | 15,060,000 | |
| 4. American Medical Association | 8,220,000 | 3,950,000 | 12,170,000 | |
| 5. Business Roundtable | 7,360,000 | 1,890,000 | 9,250,000 | |
| 6. American Hospital Association | 7,070,000 | 3,830,000 | 10,900,000 | |
| 7. Blue Cross and Blue Shield Association | 4,640,000 | 2,120,000 | 6,760,000 | |
| 8. America's Health Insurance Plans | 3,900,000 | 2,410,000 | 6,310,000 | |
| 9. Biotechnology Industry Organization | 3,720,000 | 1,780,000 | 5,500,000 | |
| 10. American College of Radiology Association | 2,090,218 | 747686 | 2837904 | |
| 11. American Cancer Society Cancer Action Network | 2,000,000 | 1,254,000 | 3,254,000 | |
| 12. Federation of American Hospitals | 1,840,000 | 1,010,000 | 2,850,000 | |
| 13. National Federation of Independent Business | 1,565,402 | 720,874 | 2,286,276 | |
| 14. American Dental Association | 1,510,000 | 600,000 | 2,110,000 | |
| 15. American Academy of Family Physicians | 1,450,434 | 844,396 | 2,294,830 | |
| 16. Service Employees International Union | 1,382,272 | 776,573 | 2,158,845 | |
| 17. American College of Emergency Physicians | 1,376,138 | 600,395 | 1,976,533 | |
| 18. AFSCME | 1,280,000 | 760,000 | 2,040,000 | |
| 19. National Association of Children's Hospitals | 1,170000 | 480,000 | 1,650,000 | |
| 20. American Association of Orthopaedic Surgeons | 1,133,000 | 320,000 | 1,453,000 | |
| 21. Generic Pharmaceutical Association | 1,105,926 | 508,363 | 1,614,289 | |
| 22. Alliance for Quality Nursing Home Care | 1,092,605 | 800,000 | 1,892,605 | |
| 23. AFL-CIO | 1,080,000 | 600,000 | 1,680,000 | |
| 24. College of American Pathologists | 775,717 | 195,325 | 971,042 | |
| 25. Academy of Managed Care Physicians | 675,478 | 169,000 | 844,478 |
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