How Do We All Win?

Preemption is a legislative or regulatory action a state or federal government enacts to eliminate or reduce the authority of a lower level of government over a given issue. In recent years, state-level preemption has increasingly been wielded as a tool to suppress local-level policies, many of which aim to promote equity and address the social determinants of health. Building a broad preemption coalition that includes large and diverse set of organizations can bring significant benefits, including increased political power and mobilization of collective bases towards common goals. While there are challenges, such as differences in political orientation and coalition splitting due to carve-outs, coalition members provide insight on strategies to help build trust, cooperation, and solidarity and overcome some of these challenges. This assessment highlights coalition members’ benefits and challenges in building and strengthening coalitions, as well as strategies used to mitigate tensions and center equity in their preemption work.