As the United States evolves slowly from a corporatocracy to an oligarchy, as represented most powerfully and obviously by Elon Musk buying his way into the Oval Office, people are beginning to question how we got here. The weakening of our laws and regulations regarding money in politics has led to billions of dollars being pumped into our government to influence and control the direction of our country.

But of all the financial groups that write our laws and tell our elected politicians how to vote, which ones are the most powerful? Which ones have created the world we live in today? Here are the ten biggest lobbying groups in the United States.

Background on Lobbying in the United States

Lobbying firms in America have spent more than $4 billion on influencing our government each year in 2022 and 2023, and the trend shows no sign of coming down.

Besides directly influencing elected officials, lobbying groups also have huge teams of lawyers writing legislation that they give to the politicians to introduce in Congress. They also donate millions to campaign funds and other campaign-related entities to help elect people they want in office. It is well-known that candidates and even elected officials who find themselves at odds with any of these groups will not last long in government, and may not be elected at all.

These lobbying groups also spend millions on creating and publishing their own “studies”, “surveys”, and data that heavily support their position and business interests. These studies are strongly biased and one-sided, often omitting important information. For example, much of the data and studies that opponents of universal healthcare use to support their position were created by the lobbying groups below.

If you’re looking for an answer as to why Americans spend more on healthcare than any other person in the world, yet we have lower healthcare returns and a dropping life expectancy, look no further. Of the ten most powerful lobbying groups, four are related to medicine or healthcare.

This is not a list of the biggest lobbying firms by revenue or membership. These are the groups that spent the most money on lobbying.

#10 CTIA

• 2023 lobbying spend: $17.18 billion

The CTIA used to be called the Cellular Telecommunications Industry Association before changing to the Cellular Telecommunications and Internet Association but it now only uses its CTIA initials to further distance itself from being associated with unpopular companies and issues.

It has lobbied heavily against net neutrality and against government efforts to reclassify internet access as a public utility, which would regulate the price and speed of internet services. It has repeatedly sued the government to prevent it from regulating the price of internet services.

It is largely due to the efforts of CTIA that the United States has one of the worst internet infrastructure systems and some of the most expensive yet least reliable internet in the developed world.

#9 Meta

• 2023 lobbying spend: $19.3 billion

Why was TikTok banned? Why do tech billionaires like Mark Zuckerberg have incredible influence over our politicians and our public services? Because of lobbying efforts led by Facebook (or Meta).

In 2020, Facebook employed 79 lobbyists, and as its efforts continue to pay off, this amount will only increase over time. While American consumers migrate to other social media apps, Facebook and other American tech companies are using every tool in their toolbox to force them to return to their platforms, outright banning foreign competitors.

Facebook (and Meta) have faced criticism that they are overly influenced by the Israeli government regarding censorship of human rights groups and news stories critical of Israel. It has also been accused of censoring information critical of the Republican Party and Donald Trump during election seasons.

This lobbying amount doesn’t include other funds given directly to political candidates or causes, like the $1 million given to Donald Trump’s 2024 inauguration fund, which is a legal and formalized bribery vehicle.

#8 Business Roundtable

• 2023 lobbying spend: $19.74 billion

The Business Roundtable is a group of the richest and most powerful CEOs in America. It is primarily focused on lobbying for laws that lower corporate taxes and are favorable to business, and against laws that strengthen worker protections.

The Business Roundtable was a key lobbying firm and opponent against multiple anti-trust bills, including the anti-trust bill of 1975 and the plan to form a consumer protection government agency in 1977. It was successful in gutting the Humphrey-Hawkins Full Employment Act.

It was a major opponent against the AFL-CIO bill in 1977. This bill would have strengthened labor laws and would have made it more difficult for companies to intimidate and threaten workers who were trying to form or join unions. The bill passed the House of Representatives, but the Business Roundtable publicly voted against it, lobbied intensely against it in the Senate, and successfully persuaded enough senators to kill the bill.

It was also successful in lobbying for massive corporate tax cuts during multiple presidencies and successfully killed a bill during Clinton’s term that would have limited excessive executive salaries. It supported legislation that gave enormous subsidies to companies in the healthcare industry and lobbied against healthcare reform.

In 2024, the Business Roundtable sued the U.S. government after it banned the use of noncompete agreements between companies and employees.

Overall, the Business Roundtable has championed legislation that is pro-CEO and anti-shareholder.

#7 Amazon

• 2023 lobbying spend: $19.84 billion

Amazon has successfully lobbied the U.S. government several times against legislation that would have impacted the enforcement of sales tax for online purchases, increasing the safety of transportation, regulated data protection, intellectual property, and more.

Amazon is notorious for neglecting or openly ignoring the health and safety of its workers and drivers, forcing them to work through natural disasters or in extreme heat without air conditioning. It has continuously lobbied against stronger worker protections.

Its lobbying efforts continue to keep the U.S. government at bay while it faces extreme criticism for its abuse of workers, price gauging, monopolistic behavior, anti-competitive practices, theft, privacy violation, and breaking of corporate laws and rules.

#6 American Medical Association

• 2023 lobbying spend: $21.22 billion

On average, the American Medical Association has spent $18 million every year on lobbying Congress for the past several decades, usually split equally between the two major parties.

It has successfully lobbied for restricting the medical supply for physicians and shutting down medical schools. It lobbied to reduce the number of doctors that were allowed to be trained in the United States. It successfully lobbied to limit how much Medicare could reimburse hospitals for care. This has led to a severe shortage of doctors in America and caused around 25% of all doctors to be trained abroad.

As a result, the American Medical Association lobbied to restrict the number of foreign doctors who could come to America.

The American Medical Association has repeatedly and strongly opposed any healthcare reform that would make healthcare more affordable or accessible for Americans. It has supported limits to medical malpractice damage awards, opposed a single-payer healthcare system, and more.

#5 Pharmaceutical Research & Manufacturers of America

• 2023 lobbying spend: $27.63 billion

The Pharmaceutical Research & Manufacturers of America lobbies exclusively on behalf of American pharmaceutical corporations.

It has lobbied strongly, consistently, and fiercely against allowing Medicare to negotiate the price of drugs for Medicare members and has even sued the government on a number of occasions to prevent price control measures from being passed or implemented.

It has successfully fought against price limits on the state level and against price transparency for U.S. drugs. It lobbies against lowering drug prices internationally, as well. It successfully lobbied against lowering the price of COVID-19 vaccines in poor countries.

It gives huge amounts of “dark money” (money spent to influence elections that are not revealed to the public) to right-wing advocacy and extremist groups.

#4 Blue Cross Blue Shield Association

• 2023 lobbying spend: $28.59 billion

The Blue Cross Blue Shield Association is a group of independent health insurance companies that insure more than 115 million people in the United States. It used to be a non-profit organization before allowing its members to be for-profit in 1994, and the annual profits of some of its members jumped into the billions. It then lobbied strongly against the Affordable Care Act, which threatened many of its special tax breaks.

Because of its huge network and control over American doctors, BCBS has enormous influence over the medical industry. It has faced antitrust lawsuits and suits for denying necessary medical care.

In 2024, BCBS announced that it would stop paying for anesthesia during surgery, and other members announced they would not cover anesthesia after a certain time limit. They later reversed this decision after UnitedHealthcare CEO Brian Thompson was assassinated by a working-class hero in late 2024.

#3 American Hospital Association

• 2023 lobbying spend: $30.24 billion

The American Hospital Association represents over 5,000 hospitals and other providers in the United States.

Since its founding in 1898, the American Hospital Association has been successful in lobbying against Medicare for All and other affordable healthcare options. It has sued the government multiple times to prevent hospital prices being made public. It is vigorous in its lobbying against giving “free care to low-income people who lack medical insurance” and against efforts to reduce the cost of healthcare in general.

It sued the Biden administration because it prevented the American Hospital Association from selling the data of visitors to healthcare websites to third parties.

#2 National Association of Realtors

• 2023 lobbying spend: $52.40 billion

The National Association of Realtors is the largest trade association in the United States with over 1.5 million members. It owns the trademark for the word “realtor”, controls government regulation over residential and commercial real estate markets, and is widely regarded as one of the most powerful financial interests in the country. It has spent nearly a billion Dollars on lobbying since 1998.

It regularly gives over $4 million to political candidates who promise to pass or support realtor-friendly legislation.

The National Association of Realtors has traditionally supported racial segregation and prohibited its members from allowing black families to move into white neighborhoods. It also opposed the Fair Housing Act of 1968.

It has faced numerous antitrust lawsuits and has been blamed for contributing to the 2008 financial crisis.

#1 U.S. Chamber of Commerce

• 2023 lobbying spend: $69.58 billion

Despite what its name might imply, the U.S. Chamber of Commerce is not part of the government but the largest corporate lobbying group in the country. It is funded by the largest corporations in the country.

Throughout its history, the U.S. Chamber of Commerce has opposed the Employee Free Choice Act (which would have strengthened labor unions and worker protections), the American Clean Energy and Security Act, the Dodd/Frank legislation reform, anti-tobacco laws, opposed healthcare reform, opposed the DISCLOSE act (which would have reduced the amount of foreign influence on U.S. elections), and more.

It hired well-known economists to produce reports and studies that showed that healthcare reform would kill jobs and threaten the nation’s economy.

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