From employment optional to “Employment First”: Explaining two cases of state-level disability policy change

Over the last three decades, the United States has increasingly devolved social policy decisions from the federal to the state level. These changes have resulted in substantial variation in policy decisions and related outcomes. Just as the changes allow states to act as policy laboratories, they also offer a window into the process by which organized interests take advantage of such opportunities to influence state-level policy. This study uses the Advocacy Coalition Framework to illuminate the black box of policy change with a comparative study of two states, Washington and Pennsylvania, which adopted “Employment First” policy aimed at prioritizing employment services for individuals with disability. The study reveals that policy change in both states was associated with organized stakeholder mobilization, strategic framing and narrative, and bureaucratic activism, all in an environment of heightened stakeholder attention to the issue. That said, the two states followed distinct paths, with early policy change in Washington stemming from service provider mobilization, suggesting the importance of policy feedback mechanisms.