Funding the war in America: A look in the mirror

Abstract

BACKGROUND Health care political action committees (HPACs) historically contribute more to candidates opposing firearm restrictions (FRs), clashing with their affiliated medical societies. These societies have increasingly emphasized the prevention of firearm violence and it is not known if recent contributions by their HPACs have aligned with their stated goals. We hypothesized that such HPACs still contribute similar amounts toward legislators up for reelection opposing FR. METHODS We identified HPACs of medical societies endorsing one or both calls-to-action against firearm violence published in the Annals of Internal Medicine (2015, 2019). House of Representatives (HOR) votes on H.R.8, a background checks bill, were characterized from GovTrack. We compiled HPAC contributions between the H.R.8 vote and election to HOR members up for re-election from the National Institute on Money in Politics. Our primary outcome was total campaign contributions by H.R.8 stance. Secondary outcomes included percentage of politicians funded and total contributions. RESULTS Nineteen societies endorsed one or both call-to-action articles. Three hundred eighty-five of 430 HOR members ran for reelection in 2020. Those endorsing H.R.8 (n = 226, 59%) received $2.8 M for $4,750 (interquartile range [IQR], $1000–$15,500) per candidate. Those opposing (n = 159, 41%) received $1.5 M for $2,500 (IQR, $0–$11,000) per candidate (p = 0.0057). Health care political action committees donated toward a median of 20% (IQR, 7–28) of candidates endorsing H.R.8 and 9% (IQR, 4–22) of candidates opposing H.R.8 (p = 0.0014). Those endorsing H.R.8 received 1,585 total contributions for a median of 3 (IQR, 1–10) contributions per candidate, while those opposing received 834 total contributions for a median of 2 (IQR, 0–7) contributions per candidate (p = 0.0029). CONCLUSION Politicians voting against background checks received substantial contributions toward reelection from the HPACs of societies advocating for firearm restrictions. However, this is the first study to suggest that HPAC's contributions have become more congruent with their respective societies. Further alignment of medical society goals and their HPAC political contributions could have a profound impact on firearm violence. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level III.