A Lobbyist Gave $900,000 in Donations. Whose Money Is It?

Mr. Rich, who joined the hospital association in 1993, has been a longtime donor to political campaigns, mostly at the state level. But his contributions have increased in recent years, according to an analysis of state filings by The Times.

They appear to represent a significant portion of his pretax income in some years. For example, in 2015, Mr. Rich made $1.5 million in total compensation and gave away $162,000 to political candidates. The next year, he made $1.6 million and gave away $128,000. (Political contributions are not tax deductible.)

“Given the donor’s job, these hefty contributions raise all kinds of questions, but the larger issue here is New York’s ridiculously high contribution limits, which invite pay to play,” said John Kaehny, the executive director of Reinvent Albany, a good government group. “The Campaign Finance Commission has to lower contribution limits, or nothing will really change in Albany.”

The hospital association is a behemoth in Albany, commanding respect and close connections in the Legislature and the governor’s office, even though it does not give money directly to candidates.

The association has, however, given more than $5 million through its for-profit arm to Democratic and Republican Party committee housekeeping accounts since 2014. It also spends heavily on outside lobbyists, employing four separate firms in the first half of 2019 for more than $415,000, according to state filings.

Greater New York forged a bond years ago with 1199SEIU, a health care workers union, and has presented a unified front against health care funding cuts. Its president, Kenneth Raske, enjoys a close relationship with Gov. Andrew M. Cuomo, and has been seated at the governor’s table at fund-raisers. (Mr. Raske earned more than $8 million in 2017.)

With the collapse of real estate’s influence in Albany evident in the rent law changes during the last session, the health care industry has remained a power center, one of the few left standing. Greater New York, whose most prominent members are New York City hospitals, is a major reason for that influence.