In Washington, DC, and across the country, elected officials are motivated by two things: the individuals who vote for them and those who communicate with them. Members of the American College of Surgeons (ACS) may communicate with policymakers via SurgeonsVoice, and they can support their campaigns through contributions to the ACS Professional Association Political Action Committee (ACSPA-SurgeonsPAC). In addition to focusing on the history and importance of PACs, this article addresses frequently asked questions about PACs; the difference between the ACS, the ACSPA, and the ACSPA-SurgeonsPAC; who can contribute to SurgeonsPAC; and how the PAC Board determines which candidates receive SurgeonsPAC support.
Background on PACs
PACs have been an important part of our democracy for nearly 80 years. PACs exist to pool resources from like-minded individuals, contribute to candidates’ campaigns, and advocate on behalf of their members’ common interests. In the 1970s, a series of campaign reform laws that allowed corporations, trade associations, and labor unions to form PACs undoubtedly helped facilitate the growth of PACs in the U.S. However, according to the Center for Responsive Politics, during the 2020 election, PACs contributed only 5 percent of funds raised, down from 9 percent in 2016.
PACs continue to focus on policy, not politics, and remain among the most transparent and regulated campaign finance entities. PAC contributions and expenditures are monitored by the Federal Election Commission (FEC) and other independent groups, such as the Center for Responsive Politics. For more information about PACs, visit OpenSecrets.org.
Most PACs represent business, labor, or other special interests and must register with the FEC within 10 days of inception. PACs may give $5,000 to a candidate committee per election (primary, general, or special)—a limit that has not increased since 1974. PACs also may contribute $15,000 annually to national party committees, such as the Democratic Congressional Campaign Committee (DCCC) or National Republican Senatorial Committee (NRSC), and $5,000 annually to other PACs and can make unlimited disbursements to Super PACs. PACs may receive up to $5,000 from any one individual, PAC, or party committee per calendar year.
PACs typically fall into one of the following three categories:
- Association PACs: These PACs are established by professional organizations, and include the ACSPA-Surgeons These PACs may accept contributions from members within their eligible class.
- Corporate (or connected) PACs: Established by businesses, labor unions, trade associations, and so on, corporate PACs raise money from a restricted class typically consisting of employees or shareholders.
- Ideological (or nonconnected) PACs: Groups with an organized mission or single-issue cause, plus members of Congress and other political decision-makers, may establish non-connected PACs. These PACs may accept contributions from individuals, connected PACs, or organizations.
Other types of PACs include the following:
- Leadership PACs: Like all PACs, elected officials and political parties are limited in directing funds to support other candidates. However, under FEC guidelines, members of Congress can establish leadership PACs and accept contributions from individuals and other PACs to help support their party. Leadership PACs cannot be used to fund personal campaign finances, but may use contributions to pay for administrative expenses, consultants, polling, and other non–campaign-related expenses.
- Super PACs: Also known as “independent expenditure-only PACs,” Super PACs can raise and spend unlimited funds but cannot coordinate or make contributions directly to candidate campaigns or party committees. Unlike traditional PACs, Super PACs may accept contributions from individuals, corporations, unions, and other groups.
The ACS, the ACSPA, and the ACSPA-SurgeonsPAC
The ACS holds a restrictive 501(c)(3) tax-exempt status that limits the range of services it can provide to and on behalf of its members. Most notably, the College’s tax classification prohibits participation in political activity.
To ensure the College maintains the standard-setting and educational activities at the heart of its mission, in 2001 the ACS Board of Governors unanimously voted to establish a new, more flexible 501(c)(6) affiliate, the ACSPA. The ACSPA is able to engage in a broader range of activities and services that benefit surgeons and patients, including an expanded legislative advocacy program and PAC. In addition to advocacy and political activities, the ACSPA structure allows for the creation of new educational and credentialing programs, the ability to provide management services to other associations, marketing new insurance and investment products, and more. At present, the ACSPA only comprises the expanded legislative action program.
ACS members hold a single and seamless membership in both the College and ACSPA. Annual ACS dues are not used to fund or support ACS political activities. A small portion (approximately 3 to 5 percent) of dues receipts are retained by the ACSPA to finance the legislative action program, and, as a result, are not tax deductible. The exact amount is listed on the back of the annual dues statement.
The ACSPA-SurgeonsPAC was established to promote access to high-quality surgical care for patients by supporting the election of federal officeholders who share surgery’s perspective on relevant policies and priorities. All political efforts are financed through voluntary contributions from ACSPA members paid directly to the ACSPA-SurgeonsPAC. All active, U.S. dues-paying members and green card holders (and their spouses), as well as ACS employees, are eligible to join SurgeonsPAC.
ACSPA-SurgeonsPAC governance and disbursements
Ranked among the top 15 PACs representing health care professionals in Washington, DC, SurgeonsPAC continues to support members of Congress who share surgery’s perspective on health care policy issues and those individuals who are positioned to advocate for ACS-supported priorities.
Established in 2002, the ACSPA-SurgeonsPAC is governed by an appointed Board of Directors composed of Fellows, Young Fellows, Associate Fellows, and Resident Members from various specialties. SurgeonsPAC, in conjunction with the federal legislative staff and surgeon advocates, works to establish relationships with policymakers on Capitol Hill.
Ranked among the top 15 PACs representing health care professionals in Washington, DC, SurgeonsPAC continues to support members of Congress who share surgery’s perspective on health care policy issues and those individuals who are positioned to advocate for ACS-supported priorities—particularly, health care professionals with demonstrated training and expertise who are well-positioned to effectively educate and engage colleagues regarding important ACS advocacy priorities. See the sidebar for a list of health care professionals’ congressional campaigns, including those to which SurgeonsPAC has contributed.
HEALTH PROFESSIONALS SERVING IN THE 117th CONGRESS
The number of health care professionals serving in Congress increased in the 117th Congress.
Following is a list of members of Congress and their area of expertise.
The ACSPA-SurgeonsPAC was established to unite surgery’s voice on Capitol Hill and therefore does not, and legally cannot, earmark contributions to specific members of Congress or contribute to candidates based on a single issue or legislative effort. SurgeonsPAC works to elect members of Congress but does not participate in presidential or state and local elections.
The ACSPA-SurgeonsPAC Board of Directors considers and evaluates congressional candidates seeking financial support. While the majority party and other key leadership positions can dictate certain disbursement decisions, SurgeonsPAC has a history of balanced giving (see Figure 1 for disbursements by party.)
FIGURE 1. DISBURSEMENT RATIOS 2005–2020
In line with the ACS mission, SurgeonsPAC upholds the highest ethical standards to ensure that contributions are distributed in a nonpartisan manner, in compliance with FEC regulations, to individuals who support excellence in surgical care and exhibit professionalism when advocating on behalf of surgery.
To review 2021 SurgeonsPAC contributions, log in (facs.org username and password) and visit SurgeonsPAC.org. Learn more about SurgeonsPAC efforts in the 2020 election at http://media.gractions.com/248/2020/december/12142020/AnnualReportFINAL.pdf.
Health care policy is constantly changing, with or without input from surgeons. Surgeons recognize the changing trends and challenges in health care and know what is best for surgery and surgical patient care. As Congress and the administration consider issues that affect the future of surgery, including physician payment, scope, patient care, surgical practice, and more, surgeons must be at the table.
The past year has proven difficult for all. Like other industries, the coronavirus 2019 pandemic affected how PACs conduct business, and a number of tragic events have led to increased political polarization and additional scrutiny surrounding PACs. To continue to effectively navigate this unique time, the ACSPA-SurgeonsPAC Board of Directors is committed to communicating with contributors and continuing to educate the broader ACS membership about the role of PACs and the importance of engagement.