Introduction: Health Politics and Democracy

As health policy scholars, we are quite familiar with the near-constant efforts to retrench and restrict health and social policies.In fact, we study them, hoping to make sense of what causes them and the likely health consequences.Across research with American, comparative, and global perspectives, we seek to understand welfare state retrenchment when it occurs in the form of budget cuts, reductions in the scope and generosity of programs, and the introduction of onerous administrative burdens.We document the political factors that drive such efforts to restrict eligibility, increase barriers to access, and reduce or eliminate benefits, as well as the political conditions that might mitigate them.In our efforts to understand continuity and change in health policies, as well as broader welfare state policies, we examine the actors involved, the structure of funding, the institutional context, the opinions of the public, the debates and justifications given, the laws and regulations invoked, and the likely health effects.But at this moment, in 2026, we are experiencing something qualitatively different.In the U.S., (which is an advanced case, but not the only case) attacks on long-established democratic practices and processes, as well as on more fundamental norms that underpin governing and policymaking, are facilitating, and sometimes driving, retrenchment of the welfare state (Greer et al. 2025;