• Congress 101

    Get acquainted with everything you need to know about Congress, including how the legislative process works, and which are the most influential committees and subcommittees in health policy. 

    Who makes up the Legislative branch?

    The House of Representatives is made up of 435 elected members, divided among the 50 states in proportion to their total population. For example, Wyoming has 1 representative, while California has 53 representatives, as proportionate to each state’s population. Each representative serves a 2-year term.

    The United States Senate has 100 members, with two members per state. A third of the senate is up for election every two years and each senator’s term lasts for six years. Of the 535 legislators in Congress, the majority have backgrounds in law. Only 19 legislators were physicians or health care providers prior to serving in Congress. 

    Which Congressional committees affect health care?

    Members of Congress serve on committees that allow them to specialize on specific areas of public policy. Committees draft, consider and recommend legislation to their Chamber’s full body within that committee’s jurisdiction. Because health care policy is broad, it primarily falls under the jurisdiction of the following six committees: 

    House of Representatives

    This committee has a board jurisdiction and legislates on health care, health insurance, Medicare and Medicaid, medical research as well as other unrelated issues. 

    This committee has jurisdiction over all revenue-raising measures including taxation, tariffs, Medicare and social security. 

    This committee, and more specifically the Labor, Health and Human Services, Education subcommittee, oversees funding for federal health care programs.


    This committee has broad jurisdiction over legislation pertaining to health care, employment, education and retirement. 

    This committee has jurisdiction over revenue-raising legislation including Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).

    This committee, and more specifically the Labor, Health and Human Services, and Related Agencies subcommittee, oversees funding for federal health care programs.

    Roles of Congressional staff members

    Each member of Congress has staff to assist him or her during a term in office. To be most effective in communicating with Congress, it is helpful to know the titles and principal functions of key staff. Below is a list of commonly used titles and job functions.

    Washington, D.C. Offices

    Chief of Staff This individual acts as the member’s chief policy advisor. They over see the development and implementation of policy objectives, strategies and operating plans. They also direct all activities between the member’s Congressional office and their district office(s). 
    Legislative Director This individual manages the member’s legislative staff and works with them to advise the member on all legislative areas. In addition to these duties, the legislative director may handle a portfolio of legislative issues as well.
    Legislative Assistant This individual develops and plans legislative initiatives and monitors developments within committees and on the chamber floor.  They write floor speeches, draft legislation, and meets with constituents or special interest groups on behalf of the member. In some offices, they may respond to constituent mail as well.
    Legislative Correspondent This individual tracks constituent mail and drafts responses. They may also meet with constituents or special interest groups and may assist the legislative assistant with research or by monitoring developments within committees or on the chamber floor. 

    District Staff

    District Director This person develops and implements policy objectives, strategies and operating plans for the district office(s). They also manage all district activities and staff.  
    Field Representative / Caseworker This person monitors and updates the member on district and local issues. They also act as a liaison between federal agencies and constituents. For example, if a veteran is having difficulties with the VA or a senior is having difficulties with Medicare, the caseworker will act as the constituent’s advocate within these agencies.         

    How does Congress pass legislation?

    Congress considers around 10,000 bills and resolutions in each 2-year session, but only 4 percent of those go on to become law.

    When Congress considers legislation affecting public health or primary care, your unique experience and authority are vital to the process. What you tell your lawmakers about your practice, your patients and your community has real power to improve policy.

    Download this infographic to learn more about how a bill becomes law, start to finish.

    How to get involved with AAFP Advocacy

    The Academy offers an array of resources to help you reach lawmakers and maximize the impact of your communication with them, whether by social media, phone or — best of all — in person.

    Advocate for Family Medicine

    Use the Academy's Speak Out tool to directly contact your elected officials on the issues that matter most to primary care. 

    Track Legislation

    Monitor congressional bills that could affect family physicians and know where your legislators stand on these issues.

    Become a Key Contact

    Join our network pairing AAFP members with lawmakers supportive of the legislative and policy priorities in family medicine.