Brokering health policy: coalitions, parties, and interest group influence

Assuming a position as broker between disconnected interests is one way for an interest group to influence the making of federal health policy. This study demonstrates how groups use their connections with political parties and lobbying coalitions to augment their brokerage positions and enhance their influence over policy making. Evidence is drawn from statistical analysis of 263 interviews with health policy elites and a qualitative case study of the debate over the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The results explain, in part, how interest groups play their brokerage roles as dispersed actors in a decentralized system, rather than as central mediators that intervene in a wide range of policy disputes.