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How Do Interest Groups Influence Health Policy?

When you read about a change in health policy or new health legislation at the local, state, or federal levels, chances are it came about in part because of interest groups. Their “behind the scenes” work is an important and often misunderstood function of our democratic form of government.

“I like to think of interest groups as the method in which we organize people to talk to their legislated officials,” says Justin Bell, an attorney, government relations director for the American Heart Association (AHA) in Minnesota, and an instructor in the online M.A. in Health and Human Services Administration program at Saint Mary’s University of Minnesota. Bell points out that interest groups like the AHA help collect and disseminate information of concern to the public and communicate it to government representatives. In essence, these non-profit associations act as watchdogs to both alert the public about various issues and work on their behalf with lawmakers who may be voting on those issues. 

Is “Interest Group” a Dirty Word?

In the popular imagination and in many media depictions, interest groups and lobbyists are the bad guys—back-room fast-talkers with lots of political connections and money to donate to political candidates and parties. Bell acknowledges that in some cases the stereotype is true, but points out, “everyone’s a lobbyist. As soon as you are talking to a policymaker and asking them to vote in some way, or you’re asking them to do something one way or another, you’re lobbying them. The only difference being you doing it on your own or you doing it through an interest group.” But lobbying takes a lot of time and effort that most people don’t have on a regular basis—so interest groups, which have paid employees to do a lot of the work, are the solution. “If there is a topic you are interested in, chances are there is a group out there that can help you obtain information and provide opportunities to weigh in,” says Bell.

And that back-room fast-talker? He’s not working for a nonprofit 501(c)(3) organization, which are barred from donating money to political candidates or campaigns. “Our influence comes from membership, and in the AHA’s case, science,” says Bell.

While the terms “interest group” and “lobbyist” may have negative connotations, they actually serve an important function that has existed throughout the history of the American government: organizing people and information to efficiently communicate with legislators. “Without somebody organizing constituencies, I don’t think lawmakers would get any of the information they need,” says Bell. There’s a common misconception among the public that lawmakers are or become subject matter experts on the topics they vote on. But in fact “they latch onto ideas and concepts that they find important, then they look for experts in the field to get them the science and connect them with the right people to talk to,” Bell explains. That’s where interest groups play their part.

So just who are in these interest groups? “They’re members of the public from many walks of life that care about the issue enough to be a member of that organization,” says Bell. Using the example of the American Heart Association, Bell points out that members can be anyone who has been affected by heart disease and strokes—survivors, people living with chronic conditions related to cardiovascular issues, family members of such individuals, doctors, nurses, and EMTs. They can sign up to be alerted to any or all of the issues the AHA is working on, which can range from healthy school lunches to hospital accreditation for emergency conditions related to heart attacks and strokes. “Then they can come up with ways to get involved,” says Bell.

In fact, those personal connections and stories can make a big difference. “If your job is to be up at the state capitol talking to lawmakers every day, you have a certain amount of influence. If you can produce someone from their district, from their community that can speak to that issue, that person has a ton of influence,” says Bell. Especially at the local and state levels, personal communication can be extremely powerful. Lawmakers “have a formula in their head—if they hear from one or two people, they assume there are dozens of people in their district who are thinking about that issue but aren’t coming forward,” he says. “So if they hear from two constituents, that carries a lot of weight.”

Such constituents can also become experts that legislators can call on for information in the future, Bell says. “They’ll keep your information on file and they’ll call you and say, ‘Hey, there’s a bill up that I’m not sure what to do about—do you have a thought on this or can you point me somewhere?’ As a constituent, you’ve made that relationship, and you’ve become one of their go-to knowledge sources.”

Before an issue actually comes up for a vote, an interest group—or, sometimes, a coalition of many groups that have banded together—has been working on it for a very long time. “Typically, before a bill is introduced, we’ve been doing behind-the-scenes work for one to three years, minimum,” says Bell. This can include research and information gathering as well as groundwork to gain the support of legislators and policymakers. “So by the time you are actually voting on something, you’ve got pretty much all the stakeholders on the same page, or the lines are drawn pretty clearly.”

Ultimately, interest groups can foster greater civic engagement by removing the perception of obstacles between lawmakers and ordinary citizens. When that happens, “that’s someone who is a much more engaged citizen, because now they know how easy it is to actually have their voice mean something,” says Bell. Indeed, having your voice heard is the first step toward promoting policies that can make a measurable difference in people’s lives.

A Flexible Degree

Interested in gaining knowledge in healthcare and policies? The online Master of Health and Human Services Administration at Saint Mary’s University of Minnesota can help you develop strong leadership and management skills, comprehend the variety of regulations and policies that are in place, and master financial management.