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Why It Matters
New Jersey hospitals are navigating federal budget changes with direct financial consequences. The passage of H.R. 1 is projected to reduce federal Medicaid funding to New Jersey by an estimated $3.6 billion annually, including roughly $300 million directed at hospitals, according to the New Jersey Governor's Office. For a system the size of Hackensack Meridian, which operates teaching hospitals and a medical school, the impact extends to graduate medical education funding, uncompensated care burdens, and the financial viability of programs like telehealth and hospital-at-home services. The organization's continued federal lobbying presence signals ongoing engagement with these pressures, even if the Q1 2026 filing does not specify what is being pursued.
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Lobbying Spending and Team Structure Hackensack Meridian Health filed its First Quarter 2026 lobbying disclosure, reporting $180,000 in in-house lobbying expenditures. The filing lists no specific issues, legislation, or lobbying targets—an omission that leaves the focus of the organization's Washington efforts unclear at a moment when New Jersey hospitals face substantial federal policy pressure.
The in-house filing reports $180,000—consistent with every quarter going back to at least early 2024. The in-house lobbying operation is represented by a single registered lobbyist, Sarah Lechner, who has filed on behalf of Hackensack Meridian Health across eight consecutive quarters.
In prior quarters, Hackensack Meridian retained multiple outside lobbying firms simultaneously—including Impact Health Policy Partners, Welsh Rose LLC, Daschle Group LLC, McAllister & Quinn LLC, Mercury Public Affairs LLC, and Strategic Health Care—spending a combined $227,000 in Q1 2025 alone. No corresponding outside firm filings have been disclosed for Q1 2026, suggesting a shift to in-house-only lobbying representation. No congressional staff experience was found in available records for Sarah Lechner.
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The Agenda: What Is and Isn't Disclosed
The first quarter in-house filing lists no specific issues and no legislation. This contrasts with prior quarters, which disclosed specific issue areas.
Prior in-house filings identified the following issue areas:
- First quarter 2025: Medicaid funding, reconciliation, AI Action Plan
- Second quarter 2025: Medicaid funding, reconciliation, AI
- Third quarter 2025: Medicaid funding, H.R. 1, AI
- Fourth quarter 2025: New Jersey County Option Hospital Fee Program, AI, graduate medical education
Outside firms lobbying on behalf of the health system in prior quarters covered a broader set of issues, including hospital reimbursement, telehealth, surprise medical billing, the 340B drug pricing program, hospital outpatient department payments, mental and behavioral health, and research funding including ARPA-H and NIH.
The Daschle Group previously listed the CONNECT for Health Act of 2023 (H.R. 4189) as relevant legislation, a bill that would expand telehealth coverage under Medicare.
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Broader Context: Federal Policy Pressures on New Jersey Hospitals
The policy environment surrounding large hospital systems has shifted significantly. New Jersey legislators have been vocal about the impact of federal Medicaid cuts on their state's hospitals. Sen. Cory Booker specifically called out the impact on Bergen County—where Hackensack Meridian operates—citing what he described as "the largest cuts to Medicaid in recent history." Rep. Josh Gottheimer warned that nearly 90,000 Northern New Jersey residents stood to lose coverage under the reconciliation legislation.
Beyond Medicaid, the system has been navigating a New Jersey Supreme Court ruling that rejected a hospital challenge—in which Hackensack Meridian was a named party—to the state's charity care mandate, according to Brach Eichler LLC. That ruling leaves uncompensated care costs in place, a burden that grows if federal coverage losses materialize.
On the research front, the system's Center for Discovery and Innovation secured $37.8 million in federal funding for antibiotic research in August 2025, suggesting federal engagement extends beyond defensive Medicaid advocacy.
Graduate medical education funding has also been a recurring concern. The New Jersey Department of Health's own budget documents flagged that Congress was weighing reductions to federal Medicaid reimbursements for GME programs—directly relevant to Hackensack Meridian, which operates a medical school and multiple teaching hospitals.
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The Bottom Line
Hackensack Meridian Health's first quarter 2026 in-house filing maintains the same $180,000 spending level it has held for at least two years. The absence of any disclosed issue areas or legislation makes it difficult to assess whether the lobbying agenda has shifted or simply become less transparent. What is clear is that the health system is operating in a federal policy environment with direct financial consequences—from Medicaid restructuring to GME funding to telehealth program continuity.