A decade ago, insulin became the poster child for America’s out-of-control drug prices. The 2017 death of Alec Smith, who was rationing his insulin before he died, and repeated price hikes for a 100-year-old medication (the patent for which was originally sold for $1 to a university to prevent it from being exploited commercially) sparked widespread outrage that a lifesaving medication could be unaffordable to the people who depend on it to survive.

And then politicians actually acted. Starting with a Colorado law passed in 2019, states began passing laws capping the out-of-pocket costs for many people who take insulin; 27 states (plus Washington, DC) now have such a policy. Then in 2022, Congress included a provision in the Inflation Reduction Act that established a $35 per month cap on insulin prescriptions for people on Medicare. Given the national response — drugmakers also made splashy public announcements about reducing the cash price that uninsured people pay — you would be forgiven if you thought this was the one health care cost crisis that the US had genuinely managed to solve.

But the diabetes community has a dire warning: It’s not over. Millions of people continue to struggle to pay for their insulin and having their long-term health put at risk because of, in the words of one advocate who put it bluntly, pharmaceutical greed.

“There has been so much attention and promise to action around the insulin price crisis. … There has been so much action,” said Shaina Kasper, executive director of T1 International, a global nonprofit that advocates for people with diabetes. “And shockingly, frustratingly, critically, the data from our 2024 survey showed that the rationing rates were worse than ever. Ultimately we’re facing such immense and monstrous corporate greed. … When we put a Band-Aid on one hole, another one’s going to find a way to pop out and keep profits high.”

Fixing the insulin crisis will require a multifaceted approach: drug pricing reform, insurance mandates, and possibly even public manufacturing. Out-of-pocket caps, Kasper said, were always a temporary fix for a very broken system. There is still a lot more work to do.

Why so many Americans still struggle to afford insulin

Both national and local surveys indicate that the policy changes of the past decade have not had the desired effect.

A study published last year from researchers at the Yale Diabetes Center found that people treated there were rationing insulin at the same rate in 2024 as they were in 2017; about one in four people reported some rationing due to the cost of the drug in both years. When you added in the people who rationed because of insurance delays or supply limits, more than one in three people — 38 percent — were still having trouble keeping this lifesaving medication on hand in 2024. A 2024 T1 International survey likewise found that nationwide, 34 percent of the Americans who use insulin reported rationing the medicine. (About 8.4 million people in the US rely on insulin to survive.)

Dr. Kasia Lipska, an endocrinologist and researcher who treats patients at the Yale Diabetes Center and who co-authored that study, was surprised by their findings.

“I was surprised because I’ve been looking at the policy and advocating for policy change; you think things are moving, they should be really improving,” Lipska said. “But if I talked to the nurses and our staff at the Yale Diabetes Center, they told me, ‘Of course they haven’t changed. We’re still hearing these stories.’”

How could this be? The explanation is multifaceted, according to Lipska and Kasper. 

“There’s just still a lot of holes in one who is covered by various protections and then how they’re covered and how they access this,” Lipska said. “It’s not as simple as just showing up at the pharmacy and asking for your insulin, and the sticker price is there, and that’s what you pay. It’s extremely complicated.”

For starters, millions of Americans remain uninsured and have to pay the cash price for drugs. While drugmakers make flashy announcements about helping those people, the process of enrolling for savings cards to get those lower prices can be a nightmare; one congressional investigation found in 2023 that uninsured patients were still paying an average of nearly $100 for insulin despite Eli Lilly’s pledge that its generic product would be available for $25 per vial. Even if you manage to get your discount card, the same investigation found that Lilly introduced several restrictions based on geography and needs, and that the specific insulins that are subject to these voluntary price caps are often out of stock at the pharmacy when people go to fill a prescription (while the more expensive brand name version is consistently available).

And then there are the loopholes in those existing federal and state laws. The federal $35 cap applies only to Medicare; the private insurance that covers half the country is excluded. (There have been bills proposed to extend the cap to private coverage, but they have not gone very far in Congress.) The state laws that do exist typically apply only to small-group and individual plans that are subject to state regulations; larger self-funded plans are exempt from state mandates and currently have no enforced limit on out-of-pocket insulin costs. One national estimate found that around 775,000 people who use insulin and had private insurance were protected in 2025 by the caps in states where they’d become law. But more than 1 million people in those states were not, nor were the 2.1 million commercially insured insulin users in states without a cap.

Even for people who benefit from the mandatory out-of-pocket caps instituted by Medicare and state laws, some of them still struggle to come up with $35 a month, given all of the other price hikes Americans have faced since the pandemic. They may have to navigate a complex process in order to actually receive the promised discount. And while a $35-per-month cap sounds straightforward, in practice, people can still face higher costs. Each individual person requires a unique amount of insulin and, for some of them, they might need two different kinds; the pharmacy may not have the right version and will make substitutions that lead to higher costs. That’s how one of Lipska’s patients ended up paying $140 per month for his insulin — despite being on Medicare.

“These things really add up…and frustrate people,” she said, “because what seems like a great idea is not actually how things work on the ground.”

The consequence is that, despite all the legislative activity and self-congratulations, millions of Americans are still at risk of serious health problems because they can’t get insulin.

The worst-case scenario is what happened to Alec Smith: Somebody is forced to spread their insulin so thin that they put their life is in danger. When diabetics have their blood sugar spike without insulin on hand, they can go into diabetic ketoacidosis, “which literally means your blood is turning into acid,” Kasper said. “I can speak from experience: it feels like you’re dying.”

To recover from an episode, they may have to go to the emergency room and end up taking even more insulin while eating in order to get their body back to equilibrium. But even short of an emergency, Kasper said, people who resort to rationing insulin can experience significant side effects. Prolonged high blood sugar due to rationing could lead to serious vision and nerve problems that were supposed to be a thing of the past once insulin became available.

Those were the scenarios that lawmakers wanted to prevent as they tried to make insulin more affordable. But they remain a very real threat for too many people.

The big idea that could make insulin truly affordable

If there’s good news to be found, it’s that the advocacy community is not giving up. They are sounding the alarm about the ongoing affordability crisis and urging Congress to act. But they do worry that the issue has become less urgent: The truly comprehensive mandate for insulin out-of-pocket caps, which is typically introduced every Congress, was delayed this time. “This year, neither bill was introduced for over a year, and it was very concerning,” Kasper said.

But they are also placing bets on something much more profound than a price cap: the government itself procuring or even producing insulin and making it available to people at the lowest possible cost. 

“This idea that medicines should be for people and not for profit I feel like is really catching,” Kasper said. 

Some states are taking baby steps in that direction: Oklahoma passed a bill this year that would offer government funding for private companies that pledge to produce insulin and sell it at a low price. 

Others are going bigger. As I reported in 2023, California has launched a program that is eventually intended to lead to government-owned facilities producing insulin to be sold on the cheap, though it will take years until publicly owned production begins. The New York state Senate approved a similar plan this year, although funding for it didn’t make it into the state’s budget. Kasper said that she is optimistic the project will make it into next year’s spending plan, and says a lot of work is currently being done to ensure it happens.

In the future, public manufacturing could also help to address the supply problems that continue to pop up. There are only three insulin manufacturers in the US right now. As those for-profit pharmaceutical companies place more emphasis on GLP-1 production — which often takes place in the same facilities as insulin production — nonprofit initiatives could fill in the gaps.

“In this time of tariffs even, with these concerns around shortages and rising prices and the corporations having this monopoly and price gouging ordinary Americans for decades now, as we’ve seen on insulin, let’s just make it ourselves,” Kasper said.

This is a long-term vision; if you need help right now, T1 International has resources to help people get health insurance, access discount programs, and even find emergency insulin. But a more affordable future for insulin will only be possible if lawmakers feel compelled to act. Public outrage created one round of reform, but the risk of political complacency is real. So if you care about this issue and want to get involved, T1 International also has a tool kit for people who want to advocate for policy changes, including around public pharma.

“The general communication that we’ve been hearing is that the insulin price crisis is over,” Kasper said. “Everyone should have access to a $35 copay for insurance. As the data shows, as we’ve been talking about, that is just not true.”

On stage at Davos in the Swiss Alps earlier this year, Bill Gates, before an audience of the global do-gooding elite, announced a $50 million partnership between his foundation and an unlikely new ally, OpenAI, aimed at improving healthcare in Rwanda.

Just a month earlier, the Gates Foundation had released a harrowing report about widespread global health cuts and collapsing foreign aid infrastructure, documenting a rise in child deaths for the first time this century. But at Davos, even as the US hemorrhaged funding for vaccines, maternal healthcare, and HIV treatment, the Microsoft co-founder struck an optimistic tone. 

“Using innovation, using AI,” Gates told Reuters, “I think we can get back on track.”

As it turns out, the partnership was just an opening salvo for what’s become a wholesale embrace of AI by the world’s largest global health philanthropy. A $200 million partnership with Anthropic came just a few months later. And then, on Tuesday, the Gates Foundation announced a plan to dole out a jaw-dropping $1 billion over the next two years for scaling up AI interventions across healthcare, education, and agriculture around the world. 

The sense that AI will soon change everything, and mostly for the worse, has perhaps never felt so pressing and alarming as it does right now. But this hefty new commitment is premised on the idea that AI could eventually make our lives much better too. In a country like America, AI requires massive investments and buildout — in the grid, in power, in technology, in water. In many parts of Africa, already infrastructure-poor, the foundation is effectively betting that AI can compensate for some of the infrastructure that isn’t in place or that has been lost — and offer a new layer that can help in education, in delivering healthcare, and more. 

The Gates Foundation’s new commitments include projects to improve how farmers analyze their crops, how doctors diagnose patients, and how students learn. Some have already proven to be quite effective, according to the foundation, with one tool improving the accuracy of medical diagnoses by 16 percent across several Kenyan clinics. “In poorer countries with enormous health worker shortages and lack of health systems infrastructure,” Gates wrote on his blog earlier this year, “AI can be a game-changer in expanding access to quality care.” 

Last year’s foreign aid cuts were unfathomably destructive for some of the world’s poorest countries, shuttering thousands of clinics and perhaps hundreds of thousands of classrooms in places where critical workers and supplies were already stretched thin. No, AI cannot deliver a baby, administer a vaccine, or manage a classroom — not yet, at least — but it can, the Gates Foundation hopes, help ease the burden and augment the quality of care for nurses and teachers now tasked with serving far more people than any one person should. 

“This is the most transformative technology of our lifetime,” Mark Suzman, CEO of the Gates Foundation, told me, and while there are “very real risks and challenges” surrounding AI, it also presents genuine opportunities to tangibly improve many people’s lives.  

It is a tantalizing premise: We can’t afford to build clinics, hire teachers, or lay new power lines, but perhaps AI could create the digital infrastructure needed to help billions of people do more with what they have — or rather, with what’s left. The question is, can the right layer of innovation help bolster a buckling system, even as the physical and logistical infrastructure surrounding it crumbles?

Is AI really what global health needs right now? 

Most Americans have yet to see AI improve their lives in meaningful ways, much less those living in poverty or in countries where only a sliver of the population has ever used ChatGPT. 

But those numbers in the developing world are slowly changing, a shift enabled in part by other global health funders convinced that as foreign aid dries up, AI could soon help the world do more with less. The Trump administration itself is on board with this thinking, so long as it benefits American tech companies. Last year, the State Department announced a $150 million partnership with the drone company Zipline to transport medical supplies in several countries.

To Zipline’s credit, an NPR reporter in Rwanda last month found that the company’s drones were already saving lives in places with poor road infrastructure, where driving to the nearest hospital can take hours on winding hills, but where drones can deliver crucial blood transfusions within minutes. 

And yet, for Rwandans to benefit fully from these high-tech deliveries, they need staffed clinics to visit. As a result of foreign aid cuts, some of those literal landing spots are now on the verge of closing in some of the nation’s most vulnerable rural corridors. “Without the underlying infrastructure, like roads, energy and power and unless there is accessibility, rural and otherwise,” Enoh Ebong, president of the global development department at the Center for Strategic and International Studies, told NPR, “then all of these solutions will stop short.”

But just as medical delivery drones still need a clinic to fly to, most of these interventions require some layer of physical infrastructure — roads, schools, power, and quite obviously, broadband  — to function. Satellite imagery shows that some rural communities in sub-Saharan Africa quite literally went dark in the aftermath of USAID cuts. It will be much harder for their kids to prompt an AI math tutor, or for a local farmer to download a weather app. 

“We’re seeing this very much as a both/and,” Suzman told me, calling more traditional funding for education and healthcare “the bedrock for long-term economic growth,” which AI is meant to supplement, not replace. But, in practice, foreign aid cuts have left serious cracks across much of that bedrock, which could make it harder for state-of-the-art solutions to function as intended.  

It is obviously not incumbent on the Gates Foundation to pay for all of this alone – nor would it even be feasible for them to do so. And for the record, plenty of the foundation’s other grant programs are not AI-related at all. But this tension does speak to a broader question that may be felt most acutely in a context like global health, but ultimately one that touches us all: Do we spend our scarce resources on the digital infrastructure of the future at the peril of our needs right now? Could you justify buying the new $1,999 folding iPhone if you can barely afford to buy groceries? 

The answer is not actually always an easy one. It is not for us to say, for example, that just because a community lacks reliable running water, its people should be excluded from the benefits (and encumbrances) of the smartphone, especially if that smartphone can connect them to health advice they could never access otherwise, or guidance that could help them survive a drought. 

In some parts of the world, digital forms of banking arrived long before local brick-and-mortar branches did, instantaneously connecting countless people to a cheap and secure way to save and send their cash to family and friends in need. It is certainly possible that AI, or at least the kind of applications the Gates Foundation funds, could one day have a similarly transformative effect on how people access personalized levels of care, education, and other services in places without the resources to do so otherwise. 

That is the hope, but it is also hard right now to believe uncritically in a technology that, as Gates himself blogged just last month, “will either be the greatest equalizer ever invented, or the worst source of injustice,” ushering in “one of the most turbulent times in human history.” 

In an interview with the New York Times soon after, he seemed convinced that AI will likely do more harm than good. “I don’t like bringing bad news to people, and I don’t like saying that innovation may be a net negative,” he said. “But that’s where we are.”

Now he wants billions of people around the world to use it? Yes, Suzman said, because if not, then inevitably the best parts of AI — the potential for exponentially better cancer treatments, for example — will go only “to those who can pay for it,” while the worst parts of it will fall, as they so often do, on those who benefit the least. “These decisions are being made now,” he said, “and the decisions being made now will then probably shape the following two decades.” Here’s hoping they’re good ones.

Russ Kremer is a longtime hog farmer in the Missouri Ozarks, where his 2,000 pigs have plenty of space to roam on his 150 acres. He doesn’t feed them antibiotics, and you won’t find a single animal in a cage. Kremer is decidedly anti-industrial hog farming.

Whenever he sends his pigs to slaughter, like every hog farmer in the US, he’s legally required to give over a small share of his sales — 35 cents for every $100 — to the National Pork Board.

If you’re not a hog farmer, you might not have heard of the National Pork Board. But you’ve probably seen its ads. Its job is to promote pork to consumers, and it’s the group behind the once ubiquitous slogan “Pork. The Other White Meat.”

The idea behind the National Pork Board — financed with mandatory contributions from Kremer and virtually every other American hog farmer — is that all pork producers should benefit from this kind of prominent marketing to buoy their product. So a dollar or so from each pig should be worth it. 

The group’s funds, by law, are limited to advertising and research. They specifically can’t be used for political lobbying to influence legislation. There’s a good reason for that: While boosting pork consumption should help any pig farmer, when it comes to laws and policies, some benefit certain types of producers over others, such as more industrial producers. And because virtually all farmers have to pay into the fund, it seems only fair to keep it policy-neutral. 

It’s essentially a tax, one that consumers indirectly pay each time they buy any kind of pork, too. “I’m not opposed to paying a tax if the tax does us some good,” Kremer told me. But Kremer and many of his fellow anti-industrial hog farmers believe it is not doing good. That’s because the National Pork Board has moved millions of their dollars to the largest industrial pork lobby in America. 

It’s called the National Pork Producers Council, and over the last 70 years, it has emerged as the loudest advocate for factory-farm style hog production. 

Since 1999, NPPC has spent nearly $45 million on federal lobbying on a variety of issues — including many of the kinds of policies that more humane and sustainable hog farmers like Kremer tend to benefit from, like antibiotic restrictions, pollution regulations, and protections for independent farmers who sometimes get screwed over by big meatpackers. In recent years, the group has also thrown millions of dollars into lobbying for the very unpopular practice of keeping pregnant pigs in tiny crates — a method that big, industrial operations are much more likely to use than smaller farms. 

Kremer, for his part, is the former president of the Missouri Farmers Union — the state chapter of the National Farmers Union, which is a small but mighty counterweight to the Big Ag lobby groups like NPPC.

The two organizations — which are legally required to operate as separate — have a very close relationship that has allowed the National Pork Producers Council to capture tens of millions of dollars from the Pork Board over the past two decades. According to a new, exclusive analysis of public financial transactions gathered by the Accountability Board — a nonprofit that advocates for higher-welfare animal farming — the National Pork Board has paid the National Pork Producers Council $66 million with its farmer contributions since 2004. Of the $66 million, nearly half of these financial transactions have not been previously reported in the news media. 

Critics say the financial transactions between the two organizations have effectively created something of a reverse Robin Hood effect in the pork business, in which an industrial farming lobby group has taken millions of dollars from smaller farmers only to use it against them and their typically more responsible ways of raising animals. 

Or, as Kremer calls it, a “kick in the groin.”

And it amounts to a meaningful chunk of the pork lobby’s overall budget: According to Vox’s review of the financial documents, some 18.5 percent of NPPC’s revenue has come from farmer checkoff dollars since the early 2000s.

The money stems from two sources: highly profitable trademark deals and a sizable real estate arrangement. Over the past 22 years, the pork promotion board has paid a remarkable $59.5 million to own and license a trademark package and another $6.5 million in rent to its landlord, the National Pork Producers Council. Although one of these cash transfers has been the subject of a lawsuit — and the organizations’ intertwined relationship has been repeatedly criticized by opponents of industrial agriculture, lawmakers, federal agencies, and farmers forced to pay the money — the groups’ close relationship has persisted.

The National Pork Producers Council didn’t respond to several detailed questions about the relationship and financial arrangements over email; in a statement, a spokesperson said that the deals between the organizations had been approved by the USDA and a legal challenge to one of the deals had been dismissed in court.

The National Pork Board also didn’t respond to an interview request for this story, or to detailed questions over email. And the US Department of Agriculture, which oversees the National Pork Board and has approved these deals, declined an interview request for this story, and did not respond to detailed questions over email.

The long saga of redirected pork-industry dollars shows how the interests of industrialized farming can find ways to overwhelm the interests and values of smaller-scale producers — and operate with relatively little government scrutiny. It also raises meaningful questions about whether the USDA is protecting the interests of American food consumers and farmers across the country, or just guarding the specific agenda of the largest players in the ag industry.

How Big Pork set up its federal piggy bank

The idea of a marketing fund that farmers pay into wasn’t new in 1985, when Congress created the National Pork Board. The egg industry had one, which had made the famous “Incredible Edible Egg” slogan, while a state-level dairy program later created the “Got Milk?” slogan.

They’re called “checkoff” programs, and with those funds, there were fears from the start that the pot of money that every farmer was required to pay into might be used improperly: “We should protect against making these producers de facto members of any association that they may not wish to be involved with,” Sen. Chuck Grassley (R-IA) warned at the time.

Grassley’s concern was prescient. The National Pork Producers Council had its own voluntary checkoff program, which it set up in the 1960s and aimed to raise a modest $40,000 in its first year. It then successfully lobbied to create a mandatory checkoff program in 1985, and even drafted the regulations for it — which became the National Pork Board, the fund that farmers have to pay into. Turning it from voluntary to mandatory brought in way more money — from $40,000 in 1966 to an estimated $25 million in 1987.

And even though this new pork promotion entity was supposed to be independent, the NPPC essentially ran it. The National Pork Board had eight program areas and $500 million from farmer checkoff funds to use over its first 15 years — but only two employees. So it contracted the NPPC to execute on those programs, along with handling its accounting and operations. The two groups even shared office space in Iowa for their respective headquarters. 

They were, in effect, separate groups in name only.

“It’s very difficult to tell where NPPC ends and the Pork Board begins,” Matt Penzer, chief legal officer of the Accountability Board, who analyzed the pork groups’ financial records, said about the early years of the pork checkoff program. Which was a problem, because farmer checkoff dollars weren’t supposed to be used for political lobbying — yet here was a lobbying group making money by being the Pork Board’s primary contractor.

In the late 1990s, the arrangement drew sharp scrutiny from the Clinton administration’s USDA inspector general — an internal government watchdog — which wrote in a report that the groups “should maintain an arms-length business relationship.” 

And by 2000, hog farmers voted to end the National Pork Board altogether because, according to an organizer at the time, it had “been used to promote the interests of factory farms and corporate meatpackers and hasn’t helped independent producers increase their bottom line.” (According to reporting by the Associated Press, the NPPC had paid a PR firm $48,000 in checkoff dollars in the late 1990s to “monitor” the activities of sustainable agriculture groups that had criticized it.)

The farmers won the vote, but their celebration didn’t last long. The National Pork Producers Council sued the USDA over a procedural technicality, eventually settled the lawsuit, and the Pork Board survived. The settlement, reached in 2001, preserved the farmer checkoff fund but ordered NPPC to, basically, stop running it. It also required that any deals between the two groups be conducted at “fair market value.” 

It seemed that the flow of money from the farmer fund to the pro-industrial National Pork Producers Council might grind to a halt, but instead it just took new forms. Internal emails, obtained by Penzer through separate litigation, reveal how.

The $59.5 million question

After the USDA told the two groups they needed to cut more of their day-to-day ties, they got creative and began moving money through big, expensive trademark deals and a lucrative real estate arrangement.

In 2003, the CEO of the National Pork Board had said in an email that the National Pork Producers Council needed an extra $881,000 per year. The next year, the National Pork Board began paying it more than $800,000 per year to license the “Pork. The Other White Meat” slogan for its advertising (it had previously been licensed for $1 per year). 

Then in 2006, with farmer checkoff dollars, the National Pork Board outright bought the “Pork. The Other White Meat” trademark from the National Pork Producers Council in a $60 million deal, to be paid out at $3 million annually in farmer checkoff funds for 20 years. This $3 million made up around 20 to 25 percent of the NPPC’s annual revenue at the time. 

The deal was questionable on multiple fronts. For one, the council — the lobbying group — should never have owned the trademark in the first place. By law, it was the federal government’s. Second, according to Parke Wilde, a nutrition and food policy professor at Tufts University and former USDA agricultural economist, the value of the slogan had been built with advertising funded by farmer checkoff dollars, so “they’re double paying and they’re not protecting the interests of the farmers who paid in.”

A National Pork Producers Council spokesperson defended the sale, stating it was “fully vetted and approved by USDA.” (The USDA did not respond to Vox’s questions for this story.)

Finally, when the National Pork Board stopped using the slogan in 2011, it continued to pay the annual $3 million to the Pork Producers Council, even though it could have ended the contract with a year’s notice. 

In 2018, a judge ordered an end to the payments, calling them “arbitrary and capricious.” (Penzer worked on the lawsuit against the USDA while working at Humane World for Animals, where I have also worked, but I was not involved with the effort.) A year later, the National Pork Board paid the council $3 million for the termination of the $60 million deal, which hasn’t been reported elsewhere.

But here’s where things get even more unusual. After the annual payments stopped — some 12 years and $36 million into the 20-year, $60 million deal — ownership of the “Pork. The Other White Meat” trademark package, which also included a simple “Pork” logo (that had more value at the time), reverted fully back to the National Pork Producers Council. The group then sold it all back to the National Pork Board in 2020, with the NPPC this time making $17.2 million in additional checkoff dollars from the transaction. 

Penzer said the deal “couldn’t pass a basic intellectual property course.” This deal, surfaced by Penzer after he submitted a public records request and a subsequent lawsuit against the USDA, has not previously been reported.

If, by this point, you’re lost in the minutiae of dealmaking, I don’t blame you. The long and short of it is that, despite the legal requirement that farmers’ checkoff dollars can’t be used for lobbying, the NPPC lobbying group has received over $59 million of checkoff dollars for repeated deals involving the same trademark package. 

Wilde said that many of the guardrails designed to protect the integrity of the checkoff program are simply not being followed. “And that leaves us with little assurance that the programs serve either the farmers’ interests or the public interest,” he told me.

“The money for advertising is just being used as a cover to transfer wealth to the lobbying entity,” David Muraskin, who’s long tracked checkoff programs and sued the USDA over Montana’s beef checkoff program, told Vox. Muraskin is an agricultural law professor at George Washington University Law School and a lawyer at FarmSTAND, a nonprofit that advocates against industrial agriculture. 

The National Pork Board maintains that it represents all hog farmers. But both the National Pork Board and the National Pork Producers Council work to protect and expand a hyper-industrial vision of American hog farming. The board and staff of both groups, for example, are largely composed of leaders and executives from industrial pig farms, companies, and trade groups. There is also something of a revolving door between the two groups. NPPC’s current CEO, for instance, is a former Pork Board executive, while a past NPPC president held a leadership role at the National Pork Board.

The National Pork Board’s lobbying landlord

The two groups didn’t limit themselves to tossing the “Pork. The Other White Meat” trademark back and forth to each other. They have also maintained a long-term real estate arrangement, the details of which have also not been previously reported. 

Remember that Iowa office they shared? The National Pork Producers Council, the lobbying group, owns it. The property was valued at $2.9 million in 2007 and the Pork Board agreed to a 30-year rental lease, for which it’s now likely to pay more than $13 million (with farmer checkoff funds) by the lease’s end. The NPPC has increased the rent several times. Most of those hikes were modest — though in 2022, it raised the rent by 74 percent, the same year it sharply increased spending and was engaged in two lawsuits to dismantle state animal welfare laws.

Over the course of its lease, the National Pork Board had also spent $6.58 million to improve the NPPC’s building, a detail also not previously covered by the news media.

To understand whether this real estate arrangement is unusual or not, I reached out to nearly 20 real estate brokers, appraisers, and experts, including many in Iowa. No one in Iowa agreed to speak with me at all, let alone comment on the record. One expert told me that, on its face, the lease deal itself didn’t raise any major flags. “It is possible that the initial lease rent was set at a low rate, with a large future increase, which would create a ‘fair market value,’” said Brent Ambrose, a real estate professor at Penn State. “It may be a terrible deal, but…it is possible that the terms reflect current market conditions.”

The National Pork Board didn’t respond to detailed questions about its lease.

“The office rent agreement between NPB and NPPC is reviewed and adjusted on a periodic schedule and is also approved by USDA, along with all other checkoff expenditures and contracts,” a National Pork Producers Council spokesperson told Vox over email. 

In the 2001 settlement in which the two groups agreed to operate independently, a provision specifically allowed the lease to continue.

All of this money ends up going into the budget of the NPPC. And although it’s unknown exactly which dollar goes where, the proceedings of a lawsuit several years ago appeared to confirm exactly what small farmers are worried about: that there’s no clear line preventing their contributions from going to lobbying efforts.

In a 2018 opinion in the Humane World for Animals lawsuit against the USDA for wrongly approving the 2006 trademark deal, a district court judge said that “at least some portion of the money that the Board pays NPPC… ultimately goes to influencing legislation.” But just because money from the trademark deal wound up being used to influence legislation, the judge said, doesn’t mean the deal was made for that purpose. And so, according to the judge, the groups hadn’t technically violated the law.

But Muraskin argues these deals have all added up to a convenient facade to fund a pro-industrial farming lobby group with required dollars from every pig farmer. 

“It seems like they’re paying for a logo that has limited value, if [any] at all, and an office space that they’re paying well in excess of what they should be,” to move money from the National Pork Board to NPPC, which in his view, “is plainly against the statute.”

It’s not a good look for a group that represents Big Pork to be perceived as taking money from small and mid-sized farmers and using it to lobby against those farmers’ interests, and it’s been a source of controversy for decades. So how and why have they managed to continue this arrangement? 

They’re “exploiting a loophole” that the USDA has failed to address, Muraskin said. “I think the entity to blame there is USDA.”

Since 2017, Sens. Mike Lee (R-UT) and Cory Booker (D-NJ) have introduced legislation to reform the checkoff programs by prohibiting them from entering into new contracts with lobbying groups (like the NPPC), among other changes. If it were to pass, the two groups would not be able to, say, engage in a new trademark deal or renew the rental lease when it expires. 

“America’s farmers are being ripped off by federal checkoff programs that take farmers’ money and play favorites with who they serve,” said Lee in a press release last year. The bill lost a floor vote during 2018 Farm Bill negotiations; it’s been reintroduced several times since but hasn’t been taken up for a vote.

The pork lobby is using farmers’ money to try to keep pregnant pigs in tiny cages

If you want a clear idea of why Kremer and other producers are upset about helping subsidize the NPPC, look no further than the biggest, most expensive battle the lobby is currently waging: A fight centered around the publicly unpopular practice of keeping pregnant sows confined to tiny crates for nearly their entire lives. 

Called “gestation crates,” which are so small the pigs can’t even turn around, these enclosures have been widely condemned by animal welfare groups and veterinarians as inhumane, and voters tend to agree. California and Massachusetts have banned — via ballot measures — any pork sold in their states coming from farms that use these crates. (Disclosure: I worked on the Massachusetts initiative.) 

But many industrial-style pork producers are heavily invested in continuing to use the crates because it’s how they’ve bred pigs for decades, and there’s a large upfront cost to switching to a crate-free system. So the National Pork Producers Council has sued both states to overturn the anti-crate laws. One case even went to the US Supreme Court — an extremely costly endeavor — where the industry group lost.

The pork producers group has also intensively lobbied for legislation called the Save Our Bacon Act, which would overturn the state laws. This spring, the act was included in the House’s version of the Farm Bill, the legislative package that covers much of US agricultural policy. But the chance of the act making it into the Senate’s Farm Bill, and thus the finalized bill, appear slim. Senate negotiations are expected to resume this month though, so the pricey fight isn’t over yet for the NPPC. 

Smithfield Foods, the largest US pork producer — which has two seats on the National Pork Producers Council board — has supported this sort of legislation. 

Gestation crate bans help more welfare-minded farmers like Kremer compete against big industrial producers. Crate-free producers have been able to continue to sell their pork into California and Massachusetts, while farms that did use the crates had to spend money to retrofit their barns or lose out on participating in those markets. Some big producers have been going in that direction, too: One of the nation’s largest pork companies, Clemens Foods, strongly opposes the Save Our Bacon Act because the company has already moved away from gestation crates.

Talking to Kremer and other pork producers who long ago abandoned keeping pigs in small cages, I’ve gotten the sense that these dollars moving from their hog sales to the sorts of lobbying efforts behind the Save Our Bacon Act and other pro-industrial policies mean more to them than the actual monetary amount. “They’re going after producers like myself,” Kremer told me of the fight over gestation crates. “And so yes, I feel more betrayed by them than ever.”

Without reforms within USDA or forced by Congress, it’s hard to see a way out for farmers like Kremer who have no option but to continue to give up a small share of their profits to organizations that sometimes actively fight against their interests. 

But that goes for consumers, too: Each piece of bacon, rib, or pork chop purchased indirectly funds an advertising pot encouraging people to buy more pork. 

And as the latest findings on the pork checkoff program reveal, some funds also go into fighting to uphold farming approaches that put profits over animal welfare and continue practices most Americans oppose, and that many have already voted to abolish.