During his term as a Shelby County Commissioner, Congressman Cohen cast the deciding vote for the creation of The MED which today, as Regional One Health, has one of the finest trauma care and burn center units in the Mid-South. During his 24 years in the Tennessee State Senate, Congressman Cohen amassed a strong record of passionate, honest and unselfish service. He consistently spurned special interests to stand up for the people's interests. In 1984, he drafted and passed a resolution creating one of the first state Holocaust Commissions in America to educate others about and to commemorate the Holocaust. Before he was elected to Congress, he became known throughout the state as the "Father of the Tennessee Lottery" after leading the referendum effort that instituted arguably the most successful education initiative in Tennessee history.

Since the inception of the Tennessee Education Lottery Scholarship program in 2004, over $6 billion has gone to students continuing their education at the college level. As a State Senator, Congressman Cohen fought for nearly twenty years before the State Lottery was established. Countless students have benefited from Congressman Cohen's tireless efforts to provide Tennesseans with access to affordable, quality, post-secondary education. Upon election to the U.S. House of Representatives in 2006, Congressman Cohen immediately distinguished himself on the Hill for his thoughtful legislation and quick wit. He also quickly earned a reputation as a champion of civil rights and justice on the highly influential Judiciary Committee, with then-Speaker of the House Nancy Pelosi referring to him as the "conscience of the freshman class" in 2008. That same year, he was instrumental in passing the first-of-its-kind House resolution apologizing for the enslavement and racial segregation of African Americans. Congressman Cohen has remained a steadfast leader on issues of importance to the people of the 9th District, working closely with former President Barack Obama and leading the policy debate on issues like infant mortality, universal health care, the economy, crime and criminal rehabilitation, veterans issues, transportation and infrastructure, and of course, education. His persistence and hard work has paid off with a $30 million Choice Neighborhood grant to redevelop and revitalize Foote Homes and surrounding areas, a $15 million TIGER grant to create jobs and fund the Main Street to Main Street Connector Project to make major improvements to the Main Street corridor as well as connect to West Memphis with the Big River Crossing pedestrian and bike trail along the Harahan Bridge, an additional $9 million in the federal budget and a $2 million dollar federal grant to the city of Memphis to help reduce the backlog of untested sexual assault kits that could catch predators and prevent crime, and many other projects and policies. Congressman Cohen also lead the effort in Congress for the state of Tennessee to receive a guarantee disproportionate share hospital (DSH) allotment totaling more than $530 million over the next 10 years to help the state's hospitals and community health centers recoup expenses incurred caring for those who cannot afford to pay.

In November of 2015, Congressman Cohen was named a member of the Highway Bill Conference Committee where he worked with his colleagues from the House and Senate to craft the first bipartisan, long-term surface transportation bill in a decade to improve our nation's infrastructure. In May 2016, Congressman Cohen was named a member of the Opioids Package Conference Committee where he worked to address the opioids crisis in the United States. In January of 2017, House Democratic Leader Nancy Pelosi appointed Congressman Cohen to serve on the powerful House Democratic Steering and Policy Committee to set the Democratic policy agenda and nominate Democratic Members for committee assignments. In February 2017, Leader Pelosi appointed Congressman Cohen to serve on the House Ethics Committee.

President Obama nominated several of Congressman Cohen's recommendations for federal positions, including Judges John Fowlkes, Sheryl Lipman and Bernice Donald, U.S. Attorney Edward Stanton III, and TVA Board Members V. Lynn Evans, Ron Walter and Bishop William Graves, who have all been confirmed by the U.S. Senate. Congressman Cohen has been named the 35th most effective Democratic lawmaker by the Center for Effective Lawmaking at the University of Virginia and Vanderbilt University. In 2019 Congressman Cohen was named Chairman of the House Judiciary Committee's influential Subcommittee on the Constitution, Civil Rights, and Civil Liberties. He was also selected to join the House Committee on Science, Space and Technology and serve as Vice-Chair of the newly formed Medicare for All Caucus.

Congressman Cohen has also dedicated himself to providing outstanding constituent service to the citizens of Memphis. The doors of his District Office in the Clifford Davis/Odell Horton Federal Building are always open for constituents, and Congressman Cohen has hosted more than a hundred district events around the city. His town halls often include visiting leaders such as the late Judiciary Committee Chairman John Conyers (MI-14) and singer/activist Harry Belafonte. He has never faltered in fighting for those who do not have the power bestowed by wealth and advantage, and his goal is as it has always been- to ensure that everyone - regardless of race, class or creed - has the opportunity to achieve their American dream.