As we come out of a heated presidential election and polarizing start to 2021, a renewed interest in AAOS’ Orthopaedic Political Action Committee (OrthoPAC) has left our inboxes filled with questions. This was especially true after we announced that we were pausing political contributions during the first quarter as a result of the Jan. 6 attack on the U.S. Capitol to allow us time to evaluate our strategy going forward and to listen to our members.
As chair of the AAOS OrthoPAC Executive Committee for the past six years, I relish the opportunity and increased spotlight on our program to offer more information on both its mission and operations. This article answers some of the most frequently asked questions we’ve received and shares an update on what’s changing as we resume political contributions next month.
Why does AAOS have a political program?
To answer this question, it is important to first understand that our advocacy efforts come from the Association arm of AAOS in Washington, D.C., not from the Academy in Rosemont, Ill. In addition, OrthoPAC is funded by voluntary individual contributions, irrespective of Academy dues or membership.
Next comes the “why.” Conversations about U.S. healthcare policy will occur whether we are in the room or not, and although it is cliché to say, our priority is to be at the table and not on the menu. The government decides:
- how we’re paid (Medicare Access and CHIP Reauthorization Act,
Merit-based Incentive Payment
System, bundled programs)
- how we practice (private, employed, academic, government, telemedicine)
- what we can do (scope, prior authorization)
- who we can treat (in network, out of network, Medicare beneficiaries)
- what we can own (hospital, imaging, ambulatory surgery center)
- how we’re insured (liability, medical)
Too much is at stake for musculoskeletal care to not be a part of these policy discussions. Sitting out is not an option. If we’re not involved or at the table, someone else will tell our story—it could be another physician group, health insurer, or healthcare organization altogether. No one should be telling our story or speaking to our experiences except for us. Not only that, but it would be a disservice to our profession and patients.
Our political program allows us that opportunity to be heard and have our voices amplified. It lets us support our champions and share our message all at the same time, in tandem with traditional advocacy efforts on Capitol Hill and with regulators. The AAOS Office of Government Relations (OGR) staff meets and works with congressional staff, but face-to-face time with congressional members is crucial and even more effective when the message is delivered by orthopaedic surgeons who live in their respective districts or states.
Who does OrthoPAC support?
OrthoPAC supports the campaigns of members of Congress and candidates for federal office who understand the issues orthopaedic surgeons face daily and who will be sensitive to those concerns while making policy in office. OrthoPAC is a nonpartisan PAC, contributing to the campaigns of Democrats, Republicans, and Independents. We like to say you can’t spell “orthopaedic” without an R, D, or I. The perspectives and concerns of both Democrats and Republicans are important to our specialty, often on different issues.
At the beginning of every election cycle, the AAOS OrthoPAC Executive Committee reassesses its contribution criteria. The importance of this critical step was heightened in 2021 and involved making recommendations that were later approved by the Advocacy Council and Board of Directors. The new contribution criteria are as follows:
- OrthoPAC makes political contributions to candidates based on their character, integrity, and respect for human dignity as supported in the AAOS Code of Ethics and Core Values of Leading to Serve, Shaping our Future, and Excellence Together.
- positive input from AAOS OrthoPAC members and stakeholders (Board of Councilors [BOC], Board of Specialty Societies [BOS], State Societies, Capitol Club Members, Advisors Circle) in the specific district or state
- electability to the specified office
These new criteria are in addition to existing criteria for assessing candidates, including:
- views on issues of importance to the care of musculoskeletal patients and the maintenance and betterment of the profession of orthopaedic surgeons
- position on a committee with jurisdiction over policy issues important to the care of musculoskeletal patients and betterment of the profession of orthopaedic surgeons
- members in elected leadership positions
- history of working well with the OGR staff and sponsoring or cosponsoring legislation deemed important to AAOS
- fellow orthopaedic surgeons and physicians running for office
OrthoPAC will apply these contribution criteria to all 435 House and 100 Senate members of Congress. The updated, full contribution criteria can be viewed at www.aaos.org/advocacy/pac.
Is OrthoPAC a SuperPAC?
We think we’re super, but the answer is no; OrthoPAC is not a SuperPAC. SuperPACs are political committees that can receive unlimited contributions from individuals, corporations, labor unions, and other PACs. OrthoPAC is a traditional PAC, which is a group of like-minded people who come together to pool their resources and advocate for their shared interests.
Traditional PACs then fall into three buckets: association PACs (such as OrthoPAC), corporate PACs, and ideological PACs. PACs have been around since the 1940s after it became illegal for corporations to contribute to federal candidates. Traditional PACs, such as OrthoPAC, are the most transparent vehicle of political contributions. For example, all contributions that OrthoPAC receives that are more than $200 can be viewed at www.fec.gov, and all of OrthoPAC’s disbursements can be publicly viewed as well. Individuals can contribute only up to $5,000 per year to OrthoPAC, and OrthoPAC is limited in the amount it can contribute to federal campaigns ($5,000 per election).
Who serves on the PAC Executive Committee?
The OrthoPAC Executive Committee is made up of 17 dedicated members through a mix of slotted seats and appointments through the Committee Appointment Program (CAP).
- two at-large members
- resident fellow
- early practice member
- chair, BOS
- chair, Advocacy Council
- chair, BOC
- chair-elect, BOC
- second vice president
- chair-elect, BOS
- chair, Advocacy Resource Committee
- chair, State Legislative and Regulatory Issues Committee
- Leadership Fellows Program (LFP) representative (LFP is phasing out)
- Advisors Circle Representative
- AAOS CEO (ex-officio)
What’s next for 2021?
The OrthoPAC Executive Committee has been working to ensure that our political strategy aligns with AAOS’ values. We’ve updated our contribution criteria and our candidate questionnaire. We’ll be calling on OrthoPAC members and stakeholders for their input as we assess candidates in their respective districts and states.
Additionally, we’ll be making information about OrthoPAC easier to find at www.aaos.org/advocacy/pac. Members will be able to easily find our governing documents, contribution criteria, OrthoPAC Executive Committee members, and contributions (updated on a quarterly basis).
We’re also taking this opportunity to educate our members on the mission of OrthoPAC and the important part it plays in our advocacy for our profession and patients. Members of the OrthoPAC Executive Committee and AAOS staff would be happy to do a presentation for your practice, subspecialty group, or state.
As we near the end of the first quarter, it’s time to get back to the job at hand—the new Congress and administration that will take bold action in the first 100 days. We must be part of these policy discussions. Our profession and our patients deserve it.
John T. Gill, MD, FAAOS, is chair of the AAOS OrthoPAC Executive Committee.