2 Policy Change

To affect change is not a quick process but it is vital to the advancement of government. However, in a democracy, the process takes time. The unique circumstances that must converge in order to permit change to take affect in American politics is best illustrated by a framework proposed by John Kingdon in 1984. His theory for policy development outlines three streams: problems, proposals, and politics, which all must converge to create an ideal scenario, or a “window of opportunity”, that facilitates the creation of new policy. These windows are rare, and yet, characterize the settings of many monumental policy changes. A notable and recent example includes the passage of the Patient Protection and Affordable Care Act in 2010.

3 arrows labeled, "Problems", "Proposals", and "Policies" are pointing towards a square, which is labeled "Window of Opportunity".

Alt Text: An illustrated look at Kingdon’s Window of Opportunity Framework: 3 separate arrows, representing the 3 separate streams Problems, Proposals, and Politics, allowing converging and pointing to a square box labeled, “Window of Opportunity”.

Taking a look at the Patient Protection and Affordable Care Act¬†through Kingdon’s eyes….

Problem: The overwhelming need for updated and evidence-based healthcare that is accessible and affordable for Americans

Proposal: The Patient Protection and Affordable Care Act –which would create a health insurance marketplace, expand Medicaid, and outline essential health benefits that would be exempt from cost-sharing payments, amongst other changes.

Politics: The presidency (President Barack Obama) and Congress (Democrat majority) were in line, meaning that they were all Democrats and therefore, allies. Furthermore, the greater political sentiment at the time in the U.S. was in support of the elected leadership and their efforts to push forward such a bill.

Window of Opportunity: On March 23, 2010, the Patient Protection and Affordable Care Act became Public Law No: 111-148

Date Actions Overview
03/23/2010 Became Public Law No: 111-148. (TXT | PDF)
03/23/2010 Signed by President.
03/22/2010 Presented to President.
03/21/2010 Resolving differences — House actions: On motion that the House agree to the Senate amendments Agreed to by recorded vote: 219 – 212 (Roll no. 165).(text as House agreed to Senate amendments: CR H1920-2152)
12/24/2009 Passed/agreed to in Senate: Passed Senate with an amendment and an amendment to the Title by Yea-Nay Vote. 60 – 39. Record Vote Number: 396.(text: CR S13890-14212)
10/08/2009 Passed/agreed to in House: On motion to suspend the rules and pass the bill Agreed to by the Yeas and Nays: (2/3 required): 416 – 0 (Roll no. 768).(text: CR 10/7/2009 H10550)
09/17/2009 Introduced in House

Timeline of the Patient Protection and Affordable Care Act.

Source: https://www.congress.gov/bill/111th-congress/house-bill/3590/actions



Suggested reading and reference: Kingdon J. 1984. Agendas, alternatives and public policies. HarperCollins, New York


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