Physicians in the United States Congress have been a small minority of the members of Congress, with fluctuating numbers over the years. The number of physicians serving and running for Congress has risen over the last 50 years from 5 in 1960, down to a nadir of 2 in 1990, to a maximum of 21 in 2013 and a decrease to 14 in 2017. Possible explanations for this development have been increasing health care spending, increased health care reform debate in the United States, leading up to the Healthcare Reform Act.