How Legislators Change the Law

In the U.S., people make their voices heard through the legislative representatives they elect. Legislators—
members of Congress—have the power to make and amend laws. Every piece of legislation starts as an idea,
which might come from the average citizen, the legislators themselves, or professional lobbyists (Sullivan,
2007). Legislators can instigate changes by assessing current issues that affect their constituents, listening to
the people, and presenting proposals to their legislative bodies.
Legislators change laws through the following process: (1) A legislator proposes a new law or a change in law
by writing and submitting a bill to either the Senate or the House of Representatives of the U.S. Congress. (2)
The bill is discussed and debated in a committee, a smaller group of senators or representatives. (3) The bill is
voted on, and if a majority of the committee supports it, they send the bill to the House or Senate. (4) The bill is
debated and discussed on the floor of the House or Senate, and then all the representatives or senators vote
to reject or approve it and send it to the president. (5) The president either signs the bill into law or uses his
veto power to reject it and send it back to the Congress (Sullivan, 2007).
How to Communicate or Meet with Legislators
Healthcare workers can convince legislators to propose or approve bills that will bring about the changes they
want in the law. One channel for meeting with legislators is town hall meetings. These are open meetings
legislators hold to hear questions and comments from community members—anyone may approach and
discuss issues with the legislator. There are often opportunities to meet with the legislator for one-on-one
discussion after the general question session, too. These interactions are often short, so you might not be able
to say everything you want, but regularly attending town meetings provides you with the chance to interact with
a legislator on a personal basis. Healthcare providers can use these meetings to develop relationships with
their legislators, and create permanent communication channels with them.
Another route is sending an email or a letter directly to a legislator. Contact information for senators and
representatives can be found easily on their websites. Office addresses and email addresses are often
provided. A short personal letter or message to a legislator can be used to convince them to take a specific
position or vote for a specific bill.
Importance of Healthcare Providers and Their Influence on Policy
Many current laws and regulations affect healthcare in the U.S. Some of these might need to be changed to
improve healthcare, but legislators may not be aware of the need for these changes. In such cases, healthcare
workers can provide valuable information and insight. They can also affect healthcare policies by advocating
for legislators to vote for specific bills—ones that have been lobbied for by professional nursing organizations,
for example.
Influential Legislators
Ben Cardin, one of Maryland’s two senators, is on the Senate Finance Health Care Subcommittee and has
voted on many healthcare-related bills. In particular, he has recently sponsored legislation to improve the
Affordable Care Act (“Obamacare”), for example through the Keep Health Insurance Affordable Act (Cardin,
2020). More recently, Cardin has worked with other Maryland legislators to introduce funding for the purchase
of medical training equipment for nurses, respiratory therapists and physical therapy assistants.
In the House of Representatives, Congressman Kwesi Mfume represents Maryland’s 7th district. Together with
several other MD legislators, he sponsored a recent bill increasing funds for maternal healthcare services
across the state (Mfume, 2020). In the past, Mfume has been a member of the National Advisory Council on
Minority Health and Health Disparities, and has participated in healthcare policy research (Bowman, 2014).