Association of Physician Organization-Affiliated Political Action Committee Contributions With US House of Representatives and Senate Candidates' Stances on Firearm Regulation

Importance Many physician professional organizations have endorsed public policies, such as expanded background checks, to reduce firearm-related injury. It is not known whether physician organizations’ political giving aligns with these policy endorsements. Objectives To compare physician organization–affiliated political action committee (PAC) campaign contributions with US House of Representatives and Senate candidates’ stances on firearm safety policies and analyze whether physician organization endorsement of firearm safety policies is associated with contribution patterns. Design, Setting, and Participants This cross-sectional study compared contributions from the 25 largest physician organization–affiliated PACs during the 2016 election cycle (January 1, 2014, to December 31, 2016) with US House of Representatives and Senate candidate support for firearm regulation. Physician organization endorsement of firearm safety policies was defined by endorsement of the 2015 Firearm-Related Injury and Death in the United States: A Call to Action From 8 Health Professional Organizations and the American Bar Association. Main Outcomes and Measures Contributions to US House of Representatives and Senate candidates by stance on firearm safety legislation measured by (1) voting history on US Senate Amendment (SA) 4750, which proposed background check expansion; (2) cosponsorship of US House Resolution (HR) 1217, which sought to expand background checks and strengthen the national criminal background check system; and (3) an A rating (vs not A) by the National Rifle Association Political Victory Fund (NRA-PVF), a measure of overall candidate support for firearm regulation. Results This study examined the 25 largest physician organization–affiliated PACs during the 2016 election cycle. Twenty of 25 PACs (80%) contributed more in total to incumbent Senate candidates who voted against SA 4750 (n = 21) than to those who voted for it (n = 8), and 24 of 25 PACs (96%) contributed more in total to incumbent US House of Representatives candidates who did not cosponsor HR 1217 (n = 227) than to those who cosponsored it (n = 166). A total of 21 of 25 PACs (84%) contributed more total dollars to US House of Representatives and Senate candidates rated A by the NRA-PVF (n = 386) than to those not rated A (n = 546). Twenty-four of 25 PACs (96%) contributed to a greater proportion of candidates rated A by the NRA-PVF than candidates not rated A. Among PACs whose affiliated organizations endorsed the Call to Action, 8 of 9 (89%) supported a greater proportion of candidates rated A by the NRA-PVF than candidates not rated A, whereas 16 of 16 PACs affiliated with nonendorsing organizations supported a greater proportion of candidates rated A by the NRA-PVF. After adjustment for other political factors, the 9 PACs that endorsed the Call to Action had a lower likelihood of donating to NRA-PVF A-rated candidates compared with PACs that did not endorse the Call to Action (odds ratio, 0.76; 95% CI, 0.58-0.99;P = .04). Conclusions and Relevance Physician organization–affiliated PACs included in this study donated more funds to more US House of Representatives and Senate candidates who oppose firearm safety policies than to candidates in support of such policies. Although endorsement of the Call to Action was associated with a lower likelihood of donating to candidates who oppose firearm safety policies, the overall pattern was not consistent with professional societies’ advocacy for firearm safety.