Updated

A few weeks after the Bush administration named Medco to be one of the first Medicare (search) drug card providers, a company executive helped throw a $100,000 fund-raiser for the president that was headlined by Health and Human Services Secretary Tommy Thompson (search).

The role of Medco Specialty Pharmacy Services (search) president Alan Lotvin, a co-chairman of the mid-April event in New Jersey, is just one of the ways prescription drug card providers have reached out to Washington politicians over the last two years.

In all, companies that won approval from Thompson's department to be the first Medicare drug discount card providers spent at least $35 million lobbying in 2003, and their executives and lobbyists donated or raised hundreds of thousands of dollars more for Bush's re-election, an Associated Press review found.

Democratic rival John Kerry (search) received a much smaller amount from the same group.

While spokespeople for Thompson and Lotvin say the fund-raiser wasn't connected to the drug cards, a longtime Washington lobbyist says it provides a textbook example of how big companies sow goodwill and win access when business is pending before the government.

"I think it is generally recognized in Washington that involvement in the campaign finance process certainly often can be very helpful to your legislative agenda," said Wright Andrews, a former president of the American League of Lobbyists (search). "It does tend to provide you better access in that people logically are likely to at least ensure that they hear you out."

Lotvin's parent company, pharmaceutical-benefit manager Medco Health Solutions, and its then-owner, pharmaceutical giant Merck, together spent about $9 million on lobbying in the capital last year. Merck spun off Medco as a separate company late last summer.

"We think the Medicare discount card is good public policy and it's going to help a lot of people," Medco spokeswoman Jennifer Leone said. "We think we were chosen because we can offer a significant benefit to Medicare beneficiaries who need help paying for their prescription drugs."

Leone said Lotvin took part in the Bush fund-raiser as a private citizen and has little to do with Medco's Medicare drug card services.

HHS spokesman Bill Pierce said Thompson had "no role whatsoever" with his department's selection of Medicare drug card providers. The companies had to go through "a very long and involved process" to be certified by the department's Centers for Medicare & Medicaid Services, he said.

Dozens of companies have won HHS approval since mid-March to offer Medicare drug discount cards. Consumers began signing up for the cards last week and can begin using them in June.

Some companies can offer the cards nationwide, others only to their own plan members. Even the ability to provide them on a limited basis is potentially lucrative, attracting a client base the companies hope to keep when Medicare prescription drug coverage begins in 2006.

A handful of the winning companies make up the lion's share of the political spending.

In addition to Merck and Medco, others with seven-figure lobbying expenses in 2003 included: Blue Cross & Blue Shield Association ($9.5 million), Aetna ($3.7 million), United Healthcare ($2 million), PacifiCare ($2.1 million) and Wellpoint Health Networks ($1.7 million).

Some lobbyists who helped the companies make their case in Washington last year have strong ties to the Bush campaign or administration.

For instance, PacifiCare's lobbyists last year included Tom Loeffler, who raised at least $200,000 for Bush's 2004 campaign, and Jack Howard, a former White House employee who worked as deputy assistant to the president for legislative affairs.

Company executives also have played a role in the Bush campaign. United Health Group's chairman and chief executive, William McGuire, earned the label Bush "Pioneer" by raising at least $100,000 for Bush's campaign, as did Todd Farha, chairman and CEO of Wellcare Health Plans, and Samuel Skinner, a member of card provider Express Scripts' board of directors.

Michael Hightower, who collected at least $200,000 for the Bush campaign to become a Bush fund-raising "Ranger," is vice president of government relations for Blue Cross & Blue Shield of Florida.

The political donations of company employees of companies that won the prescription cards overwhelmingly favored Bush — at least $280,000 of their contributions went to the president's campaign compared to about $60,000 for Kerry's campaign, Federal Election Commission records show. Among the donations:

— United Healthcare employees donated roughly $59,000 to Bush, $5,500 to Kerry.

— Employees of the Kaiser Foundation Health Plan or its parent, Kaiser Permanente, have given about $17,000 to Bush and roughly $21,000 to Kerry.

— WellCare employees gave roughly $22,000 to Bush's campaign and no money to Kerry.

— Aetna workers gave at least $16,000 to Bush and $1,000 to Kerry.

— Medco or Merck employees donated at least $12,000 to Bush and $10,000 to Kerry.

Kerry's campaign sought to capitalize on the contrast.

"Under this president, the cost of health insurance and prescription drugs have gone sky-high," Kerry spokesman Chad Clanton said. "He's taken money from the drug companies hand over fist and put protecting their profits before cutting costs for consumers."

Bush spokesman Terry Holt noted that Kerry, a Massachusetts senator, missed the final Senate vote on the Medicare drug legislation. He said the money Bush received from drug card company employees represented a tiny fraction of the more than $180 million Bush has raised.

"We accept contributions from people in all walks of life, from all kinds of businesses, and we do so on the basis that they support the broad agenda the president is promoting," Holt said.