Applying Kingdon's agenda setting paradigm to the Affordable Care Act achieving decision agenda status

Health care reform has been an issue on the governmental agenda for decades and it finally found a window of opportunity for passage in March 2010. The governmental agenda are those items that individuals within and outside government are paying attention and the decision agenda are those items that are up for active decisions by the policy makers, issues that will be addressed. What were the triggers that finally moved concerns about the need for health care reform from the governmental agenda to the decision agenda? This paper will explore the factors that contributed to health reform achieving decision agenda status, using Kingdon's agenda setting paradigm, connecting problems, policy and politics. First, Kingdon's paradigm will be described as it relates to moving issues from the governmental agenda to the decision agenda and second, it will be applied to the Affordable Care Act.