The role and influence of interest groups in the healthcare sector, such as the hospital industry, insurers or physicians, are critical aspects of understanding health politics. Yet, scholarship examining the interests and actions of these actors has been surprisingly limited in health politics scholarship on Global South contexts. In India, national- and sub-national health sector reform debates have gained traction. The country’s vast, underregulated and powerful private healthcare sector plays a decisive role in shaping policy outcomes. This study explores the public-facing strategies, tactics and frames used by policy actors in the debate surrounding the Right to Health Care Act 2022 in the state of Rajasthan. We describe a policy conflict in which private healthcare sector coalitions representing diverse constituencies united rapidly to effectively execute their opposition strategy. The opposing coalition deployed multiple approaches concurrently, pairing indirect and direct strategies and tactics and using diverse framing choices to “win” the public narrative and secure a dominant role in the policy process, placing supporting policy actors in a defensive position. Our findings contribute to a growing body of scholarship on domestic health politics in Global South contexts that expands our understanding of interest groups into different institutional and ideational spaces.