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Kuster's lobbying career

Last modified: 8/15/2010 12:00:00 AM
When Ann McLane Kuster announced her campaign for Congress last June, the Hopkinton attorney and activist noted she had never run for political office. A year later, Kuster remains the only major 2nd District candidate running for the first time.

But Kuster, a Democrat, is no newcomer to the legislative process. For 20 years before her campaign announcement, she worked the halls of the New Hampshire State House as a lobbyist representing a range of clients. Kuster's government-relations work accounted for perhaps half of the comprehensive legal services she offered, in addition to her practice arranging private adoptions, she said last week.

Kuster's lobbying work allowed her to gain expertise in education and health care policy while requiring her to take public stands on behalf of a long list of clients. It also honed her ability to negotiate with lawmakers of all political leanings. A review of her record at the State House shows how two decades working with lawmakers shaped the political portfolio of a candidate who identifies herself as a newcomer to the campaign trail.

'I think I have excellent experience in terms of how to bring people together to get things done,' Kuster said in an interview last week. 'In New Hampshire, it's often in a partnership with the nonprofit community, the business community and the state legislators that we solve issues that can help people in their real lives.'

Lobbying has taken on a bitter resonance in the 2nd District's Democratic primary. For weeks, opponent Katrina Swett has hammered Kuster about her career, which Kuster's campaign studiously refers to as 'advocacy,' rather than 'lobbying.' When the New Hampshire Union Leader reported last week that Swett had been registered as a lobbyist in Washington, the Kuster campaign denounced Swett's apparent hypocrisy. And after uncovering an old website for a Swett lobbying firm listing Katrina Swett as an associate and a company in 'global sourcing solutions' as a client, the Kuster campaign brought out unemployed workers to laud their candidate's support for job creation.

Swett has denied lobbying, and her campaign continues alerting reporters to Kuster's past work.

'Resource for legislators'

In March 1999, Kuster was at work outside Representatives Hall in the State House when she described the job of a lobbyist to a Monitor reporter.

'What I do is advocate for my clients and serve as a resource for legislators,' Kuster said. 'Here in the State House they don't have the staff and resources to do all the research they need to do, and that's where I can help.'

During her time in the State House, Kuster represented dozens of businesses, nonprofit organizations and professional associations, but within a few years she focused her practice on education and health care. She lobbied throughout her career for Dartmouth College, where she earned her undergraduate degree in 1978, and Dartmouth Medical School. Other longtime clients include the Bedford Ambulatory Surgical Center, Fidelity Investments and the New Hampshire College and University Council.

Kuster earned more than $1.3 million in lobbying fees from 1989 to 2009, according to reports she filed with the state. She earned approximately $460,000 from ambulatory surgical centers, $420,000 from Dartmouth and associations of schools and colleges, $150,000 from investment companies and associations of investment companies, and $145,000 from pharmaceutical manufacturers and their association.

During the course of 21 years representing clients at the State House, Kuster would have followed a large number of bills. Looking at even a few bills and projects that took significant attention on her part shows her handling of complex policy issues and legislative politics.

State Rep. Sharon Nordgren, a Hanover Democrat who chairs a finance subcommittee focused on health issues, said she interacted with Kuster whenever budget discussions turned to the money the state sends Dartmouth Medical School to save seats for New Hampshire students. Nordgren, a public supporter of Kuster's campaign, said Kuster was the first person she would approach for accurate information.

'We all on our committees have lobbyists,' Nordgren said. 'We use them in various ways, and there are some we trust and some we don't trust. With Annie, she was, at least in my perception, more informational and making sure we had the proper information.'

Whenever Kuster or her campaign are asked about her lobbying work, they point to her central role in the development of two state programs. When attention was focused on the rising costs of prescription drugs in the late 1990s, Kuster worked with lawmakers, medical providers and her client, the Pharmaceutical Research and Manufacturers of America, on the New Hampshire Medication Bridge Program, which allows people with low incomes to access free prescription medications. The Kuster campaign featured that program on a TV ad that began airing last week. The other program, a college savings program, allows families to pay very little tax on money saved in particular accounts.

Shawn LaFrance, who directs the Foundation for Healthy Communities, worked with Kuster during the development of the Medication Bridge program. The program was created in an attempt to connect people who needed long-term medication to prescription assistance programs offered by pharmaceutical companies, LaFrance said.

Executive Councilor Beverly Hollingworth, then president of the state Senate, had learned of local organizations that were helping patients access the programs, and she asked the Foundation for Healthy Communities to help create a statewide network. Kuster was charged with finding the startup money to organize the program but took a greater role, LaFrance said.

'She was helping way beyond just getting a contribution from the pharmaceutical association,' LaFrance said. 'She was working really closely with Bev and ourselves to make sure this thing had enough resources to take off.'

Hollingworth said Kuster went back to the drug companies to sell them on the Medication Bridge program and succeeded.

'She had to spend time convincing them this was the way to go,' Hollingworth said.

The program launched in 2001 and at its peak served 17,000 people, LaFrance said. Those numbers dropped after the federal government began offering a prescription drug program through Medicare and now stand at about 8,000 enrollees, he said.

LaFrance said pharmaceutical manufacturers have remarked upon the success of the program.

'Pfizer and some of those companies have said to us, 'Whoa, what's going on up there? We have these huge numbers of people from New Hampshire using our (prescription assistance program),' ' LaFrance said.

Kuster was also instrumental in the creation of the UNIQUE College Investment Plan, a savings plan that allows families to save for college in tax-deferred investment accounts, said Kathleen Salisbury, associate vice chancellor for government affairs at the University System of New Hampshire. Kuster drafted legislation and approached state Sen. Sylvia Larsen, now Senate president, about sponsoring the bill, Salisbury said.

'I don't think this would have happened without Annie,' Salisbury said. 'She really worked this bill hard, explaining to members of the House and Senate why this would be advantageous to families.'

PhRMA's voice

At the start of the 1995 legislative session, a Republican lawmaker from Charlestown introduced a bill that would require pharmaceutical manufacturers to sell drugs at the same price to all purchasers. The bill was intended to eliminate disparities in pricing when drugs were purchased by hospital pharmacies or HMOs, which landed competitive deals with manufacturers, and independent pharmacies, which paid a much higher price. As a representative of PhRMA, Kuster twice submitted testimony opposing the bill. After the bill was retained a year for study, Kuster wrote in October 1996 to the chairwoman of the House Commerce Committee, informing her that PhRMA would oppose any regulation controlling prices.

'We believe health care reform should rely upon market forces to insure access to medicine, contain cost, preserve quality of care and stimulate innovation,' Kuster wrote.

Kuster drew upon her familiarity with the bill's progress, reminding the chairwoman that members of a subcommittee had concluded mandatory pricing should not be legislated in the upcoming session. She noted a federal class action lawsuit had been brought by community pharmacies against brand-name drug manufacturers and said members of the subcommittee expected the topic would be addressed in the courts and U.S. Congress. Three days later, the Commerce Committee voted 10 to 3 to kill the bill.

Regulatory debate

Kuster represented the Bedford Ambulatory Surgical Center for 15 years, and in the late 1990s she engaged in a debate about state regulation of independent surgical centers. Proponents of such centers, which offered surgery at a lower cost than hospitals, said the enforcement of a law requiring state approval for significant spending on medical buildings was inhibiting entrepreneurial growth and keeping prices high for healthy patients who did not need hospital care. A group of hospitals opposed the centers, saying their expansion would threaten the hospitals' business model.

In written testimony submitted when she appeared before the House Health, Human Services and Elderly Affairs Committee in March 1999, Kuster argued that outpatient care was the indisputable future of health care, as technological advances allowed more surgeries to be performed beyond the setting of a comprehensive hospital. She offered evidence that the majority of multi-specialty surgical centers then in New Hampshire were affiliated with hospitals and that the development of surgical centers had not threatened community hospitals.

'This debate is not about whether ambulatory surgical centers are good (since hospitals are developing and supporting them) or whether community hospitals will close (as shown by Claremont and Moline (Ill.) ),' Kuster wrote. 'Instead, this debate is whether physicians themselves will be able to play an important role in the development of ASCs, or whether hospitals will be able to continue their dominance of health care services. We believe patients should have a choice.'

The Legislature decided that year to study the issue further. The topic of state oversight of medical construction has surfaced in years since, and last year a committee of legislators was convened to study the review process. Its report is due in November. Ambulatory care centers have continued to operate despite the continued existence of the review, and several have since partnered with private hospitals, said Rep. Peter Batula, a Hillsboro Republican on the Health, Human Services and Elderly Affairs Committee then and now.

In January 2004, Kuster testified before the Senate Ways and Means Committee in support of a bill to exempt private schools from paying the educational property tax. Kuster was representing the New Hampshire College and University Council, a group including the University of New Hampshire and Colby-Sawyer College, and New Hampshire Independent Schools, which included St. Paul's School and the Tilton School.

She testified that New Hampshire private schools bear a heavy tax burden, even though they educate a large number of New Hampshire students.

'As a result of the property taxes imposed on private schools, you're ultimately imposing a burden on families who choose to send their children to New Hampshire colleges compared with sending them out of state,' Kuster said, according to a transcript of the hearing. 'We're usually in here whining about the impact on the institution, but it truly is an impact on New Hampshire families and the New Hampshire economy.'

The bill died in the Finance Committee because of its $2 million price tag, said a sponsor, state Rep. John Hunt of Rindge. Hunt said he will not vote for Kuster because he is a Republican, but he once gave her a job recommendation. Hunt was impressed with Kuster's work, and when Fidelity Investments asked for a tip on a good lobbyist, he said he suggested her. Hunt said Kuster, like other successful lobbyists, was able to work with lawmakers across the political spectrum.

'At the end of the day what you want to do is get a positive vote of the committee, so you're going to lobby all the members of the committee regardless of party,' he said.

Hollingworth said her own judgment as a legislator was often informed by hearing from lobbyists on both sides of an issue. She said Kuster took part in such conversations, explaining the facts behind her client's position.

'She was willing to sit down with both sides in the room so they could both debate the issue, which I appreciated because to me that's the only way you get the whole truth out,' Hollingworth said.


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