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Whether public opinion influences positions taken by individual legislators and by party leaders on policy issues; example of health care reform; 1993-94; US. Based on interviews with 39 legislative staff members.

This article argues that explaining institutional differentiation requires the incorporation of public preferences and understandings into accounts of state development. Using primary evidence concerning policy discussions and public opinion, it suggests that culture determined the specific features of both the British National Health Service Act of 1946 and the American Medicare Act of 1965, as well as the differences between them. Examining the interaction of institutions and culture inserts democratic standards into the top-heavy Weberian discussions of state autonomy and accounts for the seemingly inexplicable failure of policymakers to ensure cost control over the new health programs.

Includes bibliographical references (p. [191]-206) and index

The Patient Protection and Affordable Care Act signed by President Obama in March 2010 is a landmark in U.S. social legislation, and the Supreme Court's recent decision upholding the Act has ensured that it will remain the law of the land. The new law extends health insurance to nearly all Americans, fulfilling a century-long quest and bringing the United States to parity with other industrial nations. Affordable Care aims to control rapidly rising health care costs and promises to make the United States more equal, reversing four decades of rising disparities between the very rich and everyone else. Millions of people of modest means will gain new benefits and protections from insurance company abuses - and the tab will be paid by privileged corporations and the very rich.

Intro -- Contents -- Contributors -- Chapter 1: Reaching for a New Deal: Ambitious Governance, Economic Meltdown, and Polarized Politics / Theda Skocpol and Lawrence R. Jacobs -- Part I: Legislative Landmarks -- Chapter 2: Hard-Fought Legacy: Obama, Congressional Democrats, and the Struggle for Comprehensive Health Care Reform / Lawrence R. Jacobs and Theda Skocpol -- Chapter 3: Eliminating the Market Middle-Man: Redirecting and Expanding Support for College Students / Suzanne Mettler -- Chapter 4: The Contest of Lobbies and Disciplines: Financial Politics and Regulatory Reform / Daniel Carpenter -- Part II: Change through Regulation and Administrative Action -- Chapter 5: The Unsurprising Failure of Labor Law Reform and the Turn to Administrative Action / Dorian T. Warren -- Chapter 6: Surprising Momentum: Spurring Education Reform in States and Localities / Lorraine M. McDonnell -- Part III: Failed Bargains and Intensifying Conflict -- Chapter 7: Obama's Immigration Reform: A Tough Sell for a Grand Bargain / John D. Skrentny -- Chapter 8: Cold Front: How the Recession Stalled Obama's Clean-Energy Agenda / Judith A. Layzer -- Chapter 9: Paying America's Way: The Fraught Politics of Taxes, Investments, and Budgetary Responsibility / Andrea Louise Campbell -- Index.

Reaching for a New Deal analyzes both the ambitious domestic policy of Obama's first two years and the consequent political backlash--up to and including the 2010 midterm elections. --from publisher description.

Charting the disparities in health and wealth in the United States, the authors explain how the inequities arise, why they persist, and what makes them worse. They outline concrete policy proposals for reform - tapping bold ideas as well as incremental changes to existing programs