Donald Trump’s nomination to lead the Department of Health and Human Services has faced criticism for being a giveaway to insurance companies, including for his ties to Wall Street.
But his most troubling nomination has been for his relationship with the Koch brothers, who have spent millions on his behalf.
Here are five things to know about his nomination.
Trump’s relationship with Koch brothers is a key factor in his health care pick.
While it’s unclear whether Trump himself is the Kochs’ biggest donor, Trump’s son Donald Jr. has made a career out of the Koch empire.
And Trump’s daughter Ivanka has a history of giving millions to the Koch network, donating $1.5 million to the group’s political action committee in 2015.
And Ivanka Trump’s father, Fred Koch, is a top Trump adviser.
Trump has also taken a number of Koch money from the family, including $500,000 from the brothers’ private foundation in 2014, according to the New York Times.
A handful of other billionaires have contributed to the Trump administration, including hedge fund billionaire Robert Mercer, who gave $1 million to Trump’s presidential campaign, and hedge fund manager Carl Icahn, who has given $250,000.
But many of Trump’s biggest donors have been relatively small, including billionaire philanthropist Paul Singer.
Trump made $12.8 million in donations from the Mercer-backed group Americans for Prosperity in the 2016 cycle, and Singer made $2.7 million from the Koch-aligned group Americans For Prosperity.
The Koch network’s ties to the administration have also been a source of contention.
A 2014 New York Post article, “Why a Trump nominee should be concerned about the Koch interests,” focused on how the Koch networks interests in healthcare could affect the Trump nominee’s views on the issue.
“As a candidate, Trump promised to bring back a healthcare system that ‘works for everybody,'” wrote the author, Charles Johnson.
“But as president, he has said he won’t change anything about Obamacare and will be more willing to work with Democrats to address the nation’s rising opioid epidemic.”
Trump and the Koch are among the few members of Congress who have not donated to the campaign.
But they have given tens of millions of dollars to Republican candidates and parties, including House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell.
And they have also given millions to candidates in other races, including Democrats like Wisconsin Senator Tammy Baldwin and Republican candidate Katie McGinty.
The health care industry has had a difficult time in the face of the opioid epidemic.
The opioid crisis has affected the health care industries, which have struggled to make ends meet amid rising costs.
And opioid deaths in the U.S. have tripled since 2016, and opioid overdoses have risen by an estimated 50% since 2015, according the Centers for Disease Control and Prevention.
The Obama administration has been particularly aggressive in targeting opioids and other prescription drugs, and has created incentives for pharmaceutical companies to produce and distribute painkillers.
But Trump has not put a significant dent in the opioid crisis, and his health insurance picks would make it harder for the industry to address opioid abuse.