As a freshman at Davidson College, Jennifer Higgins quietly planted herself in the operating room of the Duke University Hospital in Durham, North Carolina, where a prominent orthopedic surgeon was operating on a series of patients throughout the day. Higgins was holding a stopwatch. She had a job to do: clock the doc.

“I was monitoring how quickly the surgeon could turn around a surgery,” Higgins, now a Washington, D.C., healthcare lobbyist and political activist, recalls. “I clocked every procedure. Turning around a surgery quickly can be a good thing or a bad thing.”

Although her family had Midwestern roots, Higgins was born and grew up in the tiny town of Hillsborough, North Carolina, to which her single mother relocated to be near her family. Higgins worked in hospitals throughout her high school career. At sixteen, she presented a slide show on how to improve techniques to hospital administrators. The man who flipped slides for her later helped her get a job. She was planning to be a doctor.

Even though she lived in North Carolina, Higgins says, “I grew up on casseroles and mid-western values, if you will.” Her grandfather, who lived nearby, was a no-nonsense Navy man, who preached the importance of never shirking responsibilities. “I was brought up on the idea of personal responsibility and that you had to work to get what you wanted. I never expected anything to be handed to me by anyone,” she says.

While growing up, she planned to attend Duke University, but when the time came, she found herself attracted to Davidson College. She was attracted to the academic quality of the college and because it offered her an opportunity to play Division I sports. She received a merit based scholarship from Davidson. “I wanted to play soccer and get a good education,” she says of the choice. (Higgins now serves on the Davidson Athletic Fund Board, which raises funds for operating costs and scholarships for Davidson athletic programs.)

While enjoying college sports and most of her studies, Higgins realized that there was one she didn’t like at all: physics, essential for a medical degree. Higgins was also interested in the finances of medicine: how do hospitals break even? How do families pay for medical care? “I was always interested in payment policy,” she says. An adviser asked her if she wanted to make a difference one patient at a time as a doctor or perhaps would prefer to get into the field of medical economics and make a difference that way. Dropping the idea of becoming a doctor, Higgins designed her own major, Medical Economics and Ethics. “I’m probably the most pigeonholed person you will ever meet,” she jokes.

Higgins graduated from Davidson in 2002 with the intention of going to graduate school and eventually running a hospital in North Carolina. Instead the hospital administrator who’d so gallantly flipped the slides for sixteen-year-old Jenn’s hospital improvement slide show, put her in touch with Thomas A. Scully, administrator for the Centers for Medicare and Medicaid Services under President George W. Bush. “If she’s as good as you say she is, send her to me,” Scully reportedly responded. Scully hired her to work at CMS. “I had the opportunity to advance public policy in a way I never expected,” she says. She worked for CMS from 2002 to 2004. She subsequently worked two years on Wall Street as a senior associate to the Marwood Group, a health care and financial services firm. She worked on several leveraged buyouts.

“I had a lot of fun doing this,” she says, “and it was a great way to understand how Wall Street works and how what happens in Washington affects the financial industry.” She returned to work as a partner at Capitol Health Group, LLC, where she lobbied Democrats and Republicans on health issues. In 2012, she became a principal at the firm of Tauzin Consultants, an advocacy lobbying group. A partner now at Chamber Hill Strategies, she helps corporate clients deal with the intricacies of Capitol Hill with regard to health care issues.

“My job on any given day,” she says, “is to make sure my clients’ voices are heard on Capitol Hill and to keep our clients informed. Sometimes our clients hire us to fix problems, too. Lobbying is a combination of fixing things and keeping people informed.” Although an active Republican, Higgins does not limit her client roster to conservative clients. She has been hired, for example, by a client who supports mandatory paid leave legislation. Higgins prefers Senator Deb Fischer’s approach, which would offer employers incentives to provide paid leave, but has been able to introduce her client to the relevant conservatives “interested in tackling the women’s agenda.”

When asked about the Affordable Care Act, she says, “Being a realist, I have to face it that the toothpaste is already out of the tube.” She believes that tweaks and improvements are possible but is not sanguine that ObamaCare will be replaced entirely. She believes in expanding access to health care but praises Republican governors who realized that the expansion of Medicaid was not the way to go.

She is particularly concerned that ObamaCare added to the financial problem of bad debt that so many hospitals face and believes something must be done . “You’ve seen bad debt go up rather than down as the Obama administration predicted,” she says. “The Affordable Care Act was supposed to eliminate bad debt because there was to be more insured patients. There are more patients, but still many who are not fully covered.”

A workaholic who used to live in Old Town in Alexandria but moved to the trendy Shaw neighborhood of D.C. to be closer to her office, Jenn has another cause besides health care that is near and dear to her heart: getting more Republican women elected to Congress. She was an original founder (with former George W. Bush aide Marlene Colucci and several others) of Right NOW Women PAC. The group, formed after the 2012 presidential campaign, has been characterized as a “low-fund, high-involvement” movement motivates women to get involved in politics and run for federal office. Senator Kelly Ayotte called it “the Democrats’ worst nightmare.”

In 2014 Right NOW Women PAC contributed to the campaigns of Barbara Comstock (VA-10), Joni Ernst (IA), Martha McSally (AZ-02), and Elise Stefanik (NY-21) and Marilinda Garcia, a promising candidate for New Hampshire’s 2nd District seat in Congress, who lost but who is nevertheless seen as a political figure with a future.

She is also on the board of Running Start a bipartisan organization that encourages young women to run for office and includes such prominent Democrats as Rep. Tulsi Gabbard of Hawaii. Running Start helps them early on because, “We know that in many cases, if they got to the general, they would win,” Higgins says.

When asked if the gender of a politician should be a consideration, Higgins admits that some of the issue is a matter of “optics.” She believes that sometimes women fail to attract resources early enough in a campaign. “We’ve left a lot of women on the battlefield,” she says, “and I don’t like to see that. We know that, if they got to the general, they would win.”

Republicans often give the impression that they don’t care about women. “Democrats are very good at crafting a message,” she says. “The problem for Republicans is not that we don’t care about women but that we don’t talk about it enough. The more Republican women we have in Congress, the more we are inclusive, and this makes people more interested in supporting Republicans. A big part of our challenge is making sure that people know that we are the party that represents all people.”