Who lobbies the lobbyists? State Medicaid bureaucrats’ engagement in the legislative process

Abstract

AbstractResearch on bureaucratic power typically focusses on rulemaking and policy implementation, while bureaucrats’ participation in the legislative process remains underexplored. We theorise and test a specific mechanism by which bureaucrats attempt to sway legislative outcomes, which we termindirect bureaucratic lobbying. Using a novel survey of state-based health lobbyists in 25 states, we show that state Medicaid agency staff routinely request lobbying assistance from provider associations and consumer advocates. We also provide the first systematic evidence of the conditions under which indirect bureaucratic lobbying is likely to occur. Our results suggest that individual-level policy agreement interacts with institutional factors, most notably agency performance and gubernatorial power, to increase the likelihood that bureaucrats will use this strategy to attempt to influence legislative deliberations.