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In a number of important articles and books—most notably Agendas and Instability in American Politics (1993), The Politics of Attention: How Government Prioritizes Problems (2005)—Frank R. Baumgartner and Bryan D. Jones have pioneered a distinctive approach to the study of agenda setting that has shaped research in both the U.S. politics and comparative politics subfields. The Politics of Information: Problem Definition and the Course of Public Policy in America further expands on the theme of the political determinants, and implications, of “the organization and prioritization of information.” And so we have invited a number of political scientists from a range of subfields to comment on the book and on the research agenda more generally.

President Barack Obama's two signature first-term legislative victories—the Affordable Care Act and the Dodd-Frank Act—are the law of the land, but the political battle over their entrenchment continues. The question now is whether these landmark reforms will be consolidated and create a new politics going forward. We develop an argument about the limits of policy feedback to illuminate the obstacles to durable liberal reform in the contemporary American state. We argue that political scientists have paid insufficient attention to the fragility of inherited policy commitments, and that the capacity of reforms to remake politics is contingent, conditional, and contested. Feedbacks are shaped not only by the internal attributes of policies, but also by the interaction between policy-specific characteristics, the strategic goals of officeholders and clientele groups, and the political forces arising from a contentious and uncertain political environment.

The prevailing political science wisdom is that narrow interests regularly triumph over the general public. Yet the stunning passage of broad-based policy reforms in the face of intense clientele opposition suggests that the U.S. political system has a greater capacity to serve diffuse interests than has often been thought. Some of the most provocative policy-oriented political-science research during the 1980s and 1990s examined how these surprising reform victories occurred. Unfortunately, general-interest reforms do not always stick; reforms may be corrupted or reversed after their enactment. The long-term sustainability of any given policy reform hinges on the successful reworking of political institutions and on the generation of positive policy-feedback effects, especially the empowerment of social groups with a stake in the reform&s maintenance. This paper explores the postenactment dynamics of three canonical instances of general-interest reform legislation: tax reform, agricultural subsidy reform, and airline deregulation. Only in the airline-deregulation case has the self-reinforcing dynamic required for political sustainability been unmistakably evident. For analysts and advocates of general-interest reform measures alike, the clear lesson is to attend far more closely to what happens after reforms become law.

In contrast to “targeting within universalism,” in which extra benefits are directed to low‐income groups within the context of a universal policy design, the reliance of mainstream elderly on means‐tested Medicaid benefits represents the inverse pattern of “universalism within targeting.” During moments of intense debate, policy elites have strategically reframed Medicaid as a broad‐based social entitlement, yet many politicians remain ambivalent about using a program originally intended for the poor to protect the middle class. The analysis suggests that universalism and targeting are best seen not as fixed, technical features of program structures but rather, as the political raw materials with which politicians contest the multiple and conflicting purposes of the American welfare state.

Medicare features an unusually complex financing design. The Hospital Insurance Trust Fund pays for Part A of Medicare (hospital stays), while the Supplementary Medical Insurance Trust Fund finances Part B (doctor visits,outpatient care, and certain home health services). At a time when Medicare policy is generating debate, this article takes a new analytical look at the origins and consequences of the program's peculiar bifurcated structure. Addressing historians of the U.S. welfare state as well as contemporary health policy reformers, the article focuses on the crucial role of legendary Ways and Means Committee chair Wilbur Mills in Medicare's enactment in 1965. The central theme of the article is that fiscal conservatism and a commitment to budgetary restraint constitute important elements of Medicare's original political understanding. Contrary to analysts who argue that Medicare's financing design has produced “perverse” effects, we argue that it has served a valuable social function by encouraging policy makers to confront periodically the costs of one of the largest and fastest-growing federal programs. An argument can be made that Medicare's original division requires modification in order to integrate health care delivery changes of the past few decades. It is crucial, however, for reformers not to lose sight of the policy goals, including fiscal rectitude, that motivated the adoption of Medicare's bifurcated structure in the first place.

The Obama administration has made a major investment in comparative effectiveness research (CER) to learn what treatments work best for which patients. CER has the potential to reduce wasteful medical spending and improve patient outcomes, but the political sustainability of this initiative remains unclear because of concerns that it will threaten the doctor-patient relationship. An unresolved question is whether it is possible to boost public support for the use of CER as a cost-control strategy. We investigate one potential source of public support: Americans' trust in physicians as faithful agents of patient interests. We conducted two national surveys to explore the public's confidence in doctors compared to other groups. We find that doctors are viewed as harder workers, more trustworthy, and more caring than other professionals. Through survey experiments, we demonstrate that the support of doctors' groups for proposals to control costs and use CER have a greater influence on aggregate public opinion than do cues from political actors including congressional Democrats, Republicans, and a bipartisan commission. Our survey results suggest that the medical profession's stance will be an important factor in shaping the political viability of efforts to use CER as a tool for health care cost control.

Using research to develop treatment guidelines is one way to lower medical costs and improve care. However, findings from a national survey show that the public is skeptical about this approach. Specifically, the public finds arguments against establishing research-based treatment guidelines more convincing than arguments in favor of it. Our findings suggest that for evidence-based treatment guidelines to win public acceptance, the public needs to be reassured that guidelines would not lead to the limiting of access to beneficial care.

As the new century begins, the Medicaid program is arguably at a political crossroads. Over the 1980s and 1990s, policy makers enacted major expansions in Medicaid coverage, offering significant new health benefits to poor women and children and other constituencies. In elite rhetoric and political framing, Medicaid was increasingly cast as a broad-based social welfare entitlement of value to all Americans, including middle-class citizens. Some health care advocates began viewing Medicaid expansions as a potential path to achieving universal coverage in the United States. Yet Medicaid remains a means-tested program that has been repeatedly threatened with policy retrenchment. In this essay, we scrutinize Medicaid's current status and future possibilities from a historical-institutional perspective by tracing its complex evolution since its enactment in the Social Security Amendments of 1965. Our core claim is that decisions made at the time of Medicaid's original adoption have fundamentally set the matrix for struggles over the program's unfolding development. We demonstrate that key ambiguities embedded in the 1965 act created largely unintended opportunities for policy entrepreneurs to broaden Medicaid's scale and scope as well as foreseeable vulnerabilities that must be overcome if Medicaid is to realize its full potential.