Public Health and Politics: Using the Tax Code to Expand Advocacy

Abstract

Protecting the public's health has always been an inherently political endeavor. The field of public health, however, is conspicuously and persistently absent from sustained, sophisticated engagement in political processes, particularly elections, that determine policy outcomes. This results, in large part, from widespread misunderstanding of rules governing how, and how much, public advocates working in tax-exempt organizations can participate in public policy development.

This article briefly summarizes the rules governing public policy engagement by exempt organizations. It then describes different types of exempt organizations, and how they can work together to expand engagement. Next, it identifies several key mechanisms of policy development that public health advocates could influence. Finally, it suggests some methods of applying the tax rules to increase participation in these arenas.

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References

The Code does not define “advocacy”. As a general principle, subject to the limitations discussed in the text, every charity can express, promote, and educate the public about the charity's perspective on the policies, practices, and behaviors of governments, public officials, private institutions, or individuals.

All statutory references are to the Code.

This limit applies to activity at any level of government, foreign or domestic.

Small organizations (with expenditure budgets of $500,000 or less) can spend up to 20% on lobbying. As the organization grows, the percentage limit shrinks.

Currently, for example, Section 501(c)(4) organizations must ensure that their candidate campaign intervention activities constitute less than half of their overall activities. The IRS is considering whether to modify this limit.

A charity cannot have a separate segregated fund, because such a fund can only conduct activities that a charity is prohibited from conducting.

Ballot measure advocacy, including fundraising, may trigger disclosure obligations under state or local campaign finance rules.

Candidate campaign activity may be subject to disclosure obligations under federal, state, or local campaign finance rules.