The CVS Health NOligarchy Profile
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CVS Health earns a NOligarchy Score of 15.39 out of 100, placing it in the lowest tier of corporate accountability tracked by this profile.
Current Pillar Scores
Political Access
10.3
Wealth Extraction
27.5
Playing by the Rules
6.7
Score history — 23 quarters
Tier bands show where each quarter's score falls — no numeric y-axis needed. The dashed ring marks the year-over-year comparison point. Tap any quarter but the first to see its pillar breakdown.
This score is built from three pillar grades covering from Q3 2024 through Q2 2026 (8 quarters — the two-year tracking period):
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Political Access Grade: 10.32/100. CVS Health’s lobbying and Political Action Committee (PAC) spending, combined with a network of revolving-door hires, drags this grade to nearly the floor.
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Wealth Extraction Grade: 26.98/100. Reflects a wide gap between what CVS Health pays its Chief Executive Officer (CEO) and what it pays its median employee, plus a steady flow of cash to shareholders.
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Playing by the Rules Grade: 6.51/100. Driven by $347,436,807 in total fines tied to 34 cases over 2024–2026, the worst compliance showing in this profile.
The Sector Context: CVS Health ranks 5th out of 5 companies in the federal industry classification for Health and Personal Care Retailers — dead last. The sector average NOligarchy Score is 42.7; CVS Health’s 15.39 falls far below that baseline, trailing every peer tracked in this category. For higher-scoring alternatives in this space, see the Better Alternatives section below.
The Bottom Line: A Company Fined Hundreds of Millions While Handing Billions to Shareholders
CVS Health pulled in $402,067,000,000 in global revenue (SEC EDGAR 10-K (CIK 0000064803)) — the kind of money that makes a $347,436,807 fine bill look manageable, even though it is the second-largest penalty total in its own sector. In the same stretch, the company spent $3,023,000,000 buying back its own stock and channeled roughly $6,770,000,000 in dividends to investors, while its CEO was paid 798 times more than the company’s median worker. CVS Health’s combined political and influence spending totaled roughly $22.4 million — equivalent to 278 years of median household income — while workers’ earnings stayed flat and regulators kept collecting. The fines were paid; the buybacks happened; the pay gap stayed wide. Nothing in the public record suggests these were forced choices — they were the choices CVS Health made with the money it had.
CVS Health's $22.4 million in political spending equals 278 years of median-household income — enough people, one per year worked, to fill 1.5 fully-boarded 737s.
Spending to Buy a Seat at the Table
CVS Health poured $21,215,000 into federal lobbying (Senate Lobbying Disclosure Act (LDA)) across the two-year period, on top of $1,122,500 deployed through its corporate PAC (Federal Election Commission (FEC)) and $55,840 in personal donations from its executives.
The lobbying total climbed sharply, from $3,825,000 in 2024 to $10,240,000 in 2025, before reaching $7,150,000 across the first two quarters of 2026 alone — a pace that, if sustained, would exceed the prior year. CVS Health’s lobbyists filed 22 reports on pharmacy issues, 16 on health issues broadly, 16 on Medicare and Medicaid, and 13 on insurance — a lineup that tracks directly to a company that runs a national pharmacy chain, manages a pharmacy benefit manager (PBM) business through CVS Caremark, and owns the insurer Aetna. Filings cited the Ensuring Community Access to Pharmacist Services Act (H.R. 3164) — currently in progress in committee — five times, and its Senate companion, the Equitable Community Access to Pharmacist Services Act (S. 2426), four times across 2025 and into 2026. These bills would expand pharmacists’ authority to provide clinical services, a matter of direct commercial interest to CVS’s retail pharmacy footprint. Lobbyists also cited the Patients Before Middlemen Act (S. 882) and the Protecting Pharmacies in Medicaid Act (S. 927), both targeting PBM practices — squarely relevant to CVS Caremark. Under consumer issues filings, lobbyists referenced the Combating Organized Retail Crime Act of 2025 (H.R. 2853), which addresses theft at retail stores — a pressure point for CVS’s front-of-store operations. Tax filings cited the No Handouts for Drug Advertisements Act (H.R. 3010 and S. 1785), which would restrict deductions for prescription drug advertising costs, touching CVS’s interests both as a pharmacy and as an insurer. None of these bills had been enacted as of the latest filings; most remain in progress.
The PAC split its giving nearly evenly: $368,500 to Democrats and $385,500 to Republicans — a 48.9% / 51.1% division that ensures access to whichever party controls the next Congress.
CVS Health's PAC gave $368,500 to Democrats and $385,500 to Republicans — a 48.9% / 51.1% split that buys access to whichever party wins.
48.9%
51.1%
Democrats · $368,500
Republicans · $385,500
ACCESS-BUYER PENALTY APPLIED
CVS Health’s roster of 31 registered lobbyists includes 4 with prior government positions — among them a former Chief of Staff to multiple members of Congress, a former Special Assistant to the President at the White House, and a former Director of Strategic Planning in the U.S. Department of Health and Human Services (HHS) — giving the company direct lines into the offices it now lobbies. Filings also show CVS Health sharing a lobbying firm, Kountoupes Denham Carr & Reid, LLC, with Best Buy.
Shared Lobbying Exposure
CVS Health
client
KOUNTOUPES DENHAM CARR & REID, LLC
lobbying firm
Best Buy Co Inc
also a client
Why it matters: the same firm argues CVS Health’s case and its rivals’ — one hire buys a web of shared access that can’t be seen from outside. This network worsens CVS Health’s political-access score (see methodology for the exact factor).
Pumping Up Shareholder Value While the Pay Gap Widens
CVS Health’s CEO pay ratio is 798:1, the 3-year average of Compensation Actually Paid, relative to its median employee (SEC DEF 14A). The CEO’s three-year average package was about $50.5 million. The median CVS Health employee earned $63,262 that year — not enough to cover rent in most of the major metro areas where CVS operates its national pharmacy footprint.
Across fiscal years 2024 and 2025, CVS Health spent $3,023,000,000 on a deliberate reduction in shares outstanding that inflates per-share metrics and triggers executive performance bonuses, and paid out roughly $6,770,000,000 in dividends (SEC 10-K). Both flows of cash disproportionately enriched the wealthiest 10% of Americans, who own 93% of the stock market. No employee headcount is disclosed in the tracked filings for this period, so a precise per-worker raise equivalent cannot be computed — but the scale is plain: $3,023,000,000 in buybacks directed to shareholders, against a workforce whose median salary sits at $63,262 a year.
The data shows CVS Health didn’t have to choose between its investors and its workforce. It paid out roughly $6,770,000,000 in traditional dividends across 2024 and 2025 and still could have funded a meaningful worker raise on top of it. The company simply chose not to.
Buybacks also reduce the number of outstanding shares, which mechanically inflates Earnings Per Share (EPS) — a metric directly tied to executive performance bonuses. The same executives who approved $3,023,000,000 in buybacks benefit from the resulting EPS lift, while the CEO-to-median-worker pay gap sits at 798:1.
CVS Health paid an effective tax rate of 19.1% — 1.9 percentage points (pp) below the 21% federal statutory rate that Congress set. The company’s 10-K discloses a rate reconciliation identifying the single largest item cutting the tax bill: recognition of a basis difference in subsidiaries, which reduced the effective rate by 83.9pp — though a separate goodwill impairment charge added back 56.3pp, partially offsetting that reduction. The filing also discloses that Ireland’s statutory rate differential reduced CVS Health’s tax burden by 3.1pp, and that total tax credits — covering research and development, energy, low-income housing, and other items — trimmed an additional 7.8pp from the effective rate, with energy-related credits alone accounting for 3.6pp of that reduction. CVS Health chose to pay 1.9pp less than the rate Congress set. That gap is not an accounting accident — it is a structural decision that shifts real tax burden off CVS Health’s balance sheet and onto everyone else. On top of that, CVS Health holds Unrecognized Tax Benefits equal to 15.0% of its pre-tax income — contested deductions it has claimed on its taxes that the Internal Revenue Service (IRS) has not yet agreed are valid.
Fines Treated as a Business Expense
CVS Health accumulated $347,436,807 in total fines across 34 cases over the two-year tracking period (Good Jobs First Violation Tracker) — the second-highest penalty total of any company in its sector. The source site carries the company’s full historical record; the figures here cover only Q3 2024 through Q2 2026.
The Pattern: False Claims Act and related violations account for $278,092,280 of that total across just 6 cases, dwarfing every other offense category. Insurance violations were the most frequent type, with 16 separate cases over the two-year tracking period, though their combined penalties totaled $1,937,300 — a pattern of recurring, lower-dollar insurance infractions sitting alongside a small number of very large False Claims Act settlements. This is not a story of isolated accidents; it is a recurring feature of how the company operates across its pharmacy, insurance, and healthcare subsidiaries.
INSURANCE VIOLATION
16 SEPARATE CASES
2024–2026 · $1.9 million in penalties
16 separate insurance violation penalties in 2024–2026 — CVS Health paid $1.9 million for the same category of offense, case after case.
The Big Case: The single largest fine was $117,700,000, levied in 2026 against CVS Health’s Aetna subsidiary by the Department of Justice (DOJ) Civil Division for a False Claims Act violation (Good Jobs First record). The next-largest, $60,000,000 against Oak Street Health in 2024 (Good Jobs First record), also fell under the same category, followed by a $45,000,000 consumer protection settlement with the Louisiana Attorney General in 2026 (Good Jobs First record).
The Subsidy Flip: While regulators were fining CVS Health hundreds of millions of dollars, governments were simultaneously handing the company public money. CVS Health received $4,262,013 in public subsidies across 2024–2025 (Good Jobs First Subsidy Tracker), with the two largest awards — $2,144,657 in 2024 and $2,051,971 in 2025 — accounting for nearly all of the total.