The punctuated equilibrium theory of agenda-setting and policy change

Authored by: Graeme Boushey

Routledge Handbook of Public Policy

Print publication date:  November  2012
Online publication date:  December  2012

Print ISBN: 9780415782456
eBook ISBN: 9780203097571
Adobe ISBN: 9781136223259


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On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA), marking a major shift in the organization and structure of health care in the United States. The statute outlined a series of dramatic reforms to the provision, funding and regulation of public and private health insurance, controversially requiring that all Americans carry qualifying health coverage, directing state governments to regulate new health insurance exchanges, expanding the coverage of poor and uninsured children, and designating a comparative effectiveness research institute to track the effectiveness of preventative and clinical public health (Kaiser Family Foundation 2010). 1 Although there is currently considerable uncertainty regarding the future implementation of the health care reforms, the passage of the act is nonetheless remarkable in the size and scope of policy change. The PPACA has triggered significant policy-making attention across the legal, executive, and legislative branches of both the state and federal governments. If the statute survives the current legal challenges, the PPACA will radically alter the US health care system.

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