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Health policy grant making by foundations in the 1990s.

Foundations in the United States account for only a fraction of this country’s vast health care expenditures (an estimated $2.2 billion in 1996), and almost all of this support funds direct services and medical research. 1 A small number of major health funders have made programmatic commitments to informing health care policy and policymakers through support for research, analysis, education, and advocacy. A recent Grantmakers in Health report stated, “Foundations can maximize their impact by influencing decisions on how government health dollars are spent, and by persuading government to direct funds towards concerns of the foundation.” 2 Still, only about one in ten health grantmakers make policy grants in a given year. These are typically for specific initiatives or on an ad hoc basis when a policy funding opportunity coincides with a funder’s grantmaking agenda. Regardless of their level of commitment, foundations have been active throughout the 1990s at the national, state, and local levels in awarding health policy‐related grants focused on most of the country’s pressing health care issues. This essay provides a brief overview of grantmakers’ funding in health, followed by a descriptive analysis of patterns of support for health policy in 1990 and 1995 based on a sample of foundation grants. The analysis measures the size of health policy funding, charts changes in funding from 1990 to 1995, provides examples of how policy dollars were spent, and identifies key funders.