Health Consulting

How You Can Influence Laws – A Forgotten Business Strategy

Health Consulting

By Dr. Jamie Skipper, RN, PhD and Jesse Walsh MPH

It’s probably been a long time since you were knowledgeable about civic processes, but as a business owner the knowledge of how a bill becomes law can be foundational to your business’s strategic trajectory — knowing when and how to influence policy and regulation can have significant impacts on your bottom line. Say you want to propose a law that could clear a path for tremendous growth for an industry in general, and your company in particular. Many current laws on the books are outdated for the rapid advances in health information technology, outpacing the ability of our legislative processes to keep up. If you’re not paying attention and getting solid guidance about the regulations impacting your business, a law might be proposed that could put a chokehold on the future growth of your company and you would miss your chance to fight it. By knowing the steps of legislative changes and proposals you can ensure that you act with the appropriate timing and speed to ensure your business continues to thrive within the bounds of the law.

1. The first step to creating or changing laws is recognizing that an area of law or practice has been overlooked or has come into the spotlight with technological evolutions. For example, telehealth companies have recently been working with lawmakers to advocate that telehealth services be covered at the same rate as in-person services.  Outside of working with consultants or professional advocates, these activities may be hard to track until the next step – when a bill is submitted.

2. Once the ideas and concepts for a bill are finalized, it must be drafted. While anyone can write a bill it must be sponsored and submitted to the legislature by a member of congress or the senate. If your company is actively advocating for new laws, keep in mind, that the more work you do for and with representatives, the easier it is for them to work on your behalf. Having a good working relationship with members of the house or congress who often act on health-IT bills can greatly affect the outcome of your bill proposal or amendments. When you have a proposed bill, or input on a bill, that you want considered, you (or your advocacy team) can write it up yourselves! Professional advocates routinely draft legislative language for law makers to use. Drafting your bill in the correct legislative language and presenting it to your representative or senator as a draft is the best way to get farther faster.

The Enactment Clause – This is a key part of any bill draft that you should pay close attention to – it states when the bill would go into effect if passed. This is a key detail because many people believe that once passed, a law immediately goes into effect, but this is not true. Enactment dates can vary widely and paying close attention to changing laws and regulations can give you a precious window of time to quickly alter your business model to be in compliance before you risk getting fined or worse.  If your company would be negatively affected by a new law, but the law seems likely to be passed, often a good business strategy is to advocate for an enactment date that is further in the future.

3. Once a bill has been submitted and sponsored, it is sent to the appropriate committee. Most bills die at this stage. However, it’s at this step that the public is encouraged to get involved so this is another chance to dig in! Committees often encourage members of the public to give feedback, which can have great sway in which way they vote.

During this stage there are four potential outcomes. The bill can be:

i. Tabled indefinitely.

ii. Killed.

iii. Approved in its entirety

iv. Edited by the committee, changing it a lot or not very much depending on the political landscape and make up of the committee.

4. If the bill is approved fully or with edits by the committee it then goes to the floor of whichever house it was proposed in for debate. During this stage members of the house or senate debate the bill and can propose amendments to make it more likely to gain votes and be passed. Many companies begin proposing bill language at this stage in the form of a strategic amendment that can be enveloped into a larger bill that has gained traction to be passed.  These amendments can effectively change a bill for or against your company’s goal. By working with consultants, advocates, or professional organizations, you can pay close attention to bill changes and determine whether getting more involved in legislative advocacy makes sense for your organization.

5. Once both houses have voted in favor of the bill it goes to the President or governor to become a law. If the president approves of the bill s/he will sign it into law. However if the President or governor do not approve of the bill there are a few courses of action:

a. Veto the bill, in which case it will go back to Congress with the reasons for veto – they can either redraft the bill to accommodate the  edits or override the veto with a two-thirds majority vote.

b. Do nothing. After 10 days of no action from the president the bill will automatically become a law.

c. Pocket veto, which means that if Congress ends its session before the president’s 10 days are up the bill will not become a law.

The key takeaways from this process are:

  • Timing is key – A bill must be proposed at a time when its outcome is most favorable. Things like election years, presidential approval ratings, and the bipartisan climate can kill a bill that might have been enacted a year earlier or later. Following these litmus tests can help you determine whether it makes sense to spend your company’s time on legislative advocacy.

  • Advocacy is a strategic investment – Advocacy involves acting passionately to advocate for legislative language that will benefit your company and your clients. If the topic is something that you feel passionately about or think will have a beneficial impact to your company’s mission or bottom line, then you should work hard to get it in front of the right people and make sure that people are paying attention to what you think are key points and takeaways. Strategically advocating on an issue or bill can give it prominence and traction in front of lawmakers and help you shape the legislative landscape to support your company’s goals.

  • Don’t give up and don’t stop paying attention – Many bills go through multiple cycles of this process before becoming laws. You have multiple chances to express your support or concerns, so make sure you seek competent guidance to achieve your business’s goals.

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