This paper combines methods in sociology of elites with those in public policy in order to build a new elite ideal-type (“custodians of the state”). I present the constitutive elements of this elite type – social backgrounds, occupational careers and specializations in sovereign policies sectors, formal position-holding, reputations for policy influence, and not least shared ideas – with what elites actually do in public policy decision process. By applying this approach to French health policy since the early 1980s, I highlight the structure and the increasing importance of this new elite type in the reshaping of French strong state capacity.