Trump tax bill exposes the lost clout of the health care lobby

WASHINGTON — Republicans swiftly approved President Trump’s tax cut bill last week, despite a full-court press from doctors, hospitals, and patients to beat back some of the largest health care cuts in American history — more than $1 trillion in all over the next decade.

Lobbyists’ failure to stop or even substantially modify the bill leaves concerning questions for American health care: Has the influence of the health care industry, once among the most powerful, faded in Washington? And do doctors and hospitals — sometimes proxies for patient voices in government — understand how to navigate Trump’s remade Washington?

In interviews with more than 20 Congressional staffers, lobbyists, health executives, and lawmakers through the critical days of Trump’s Big Beautiful Bill, a picture of the new dynamic has emerged, in which the health industry’s sway in Washington has substantially weakened — and in which proxies for patient voices are pushed aside.