Success Despite Veto Players, Failure Without a Solution: In Vitro Fertilization and Abortion Reform in Poland After 2023

This paper explains divergent policy outcomes in reproductive health policy in Poland after the 2023 parliamentary elections: the successful adoption of public funding for in vitro fertilization (IVF) and the failure of abortion liberalization. Both processes unfolded within the same political context, under the same governing coalition, and within the same timeframe (2023–2024), yet yielded opposite outcomes. Reproductive rights became a highly salient public issue following the Constitutional Tribunal’s 2020 ruling that further restricted abortion access, which triggered mass protests and sustained civic mobilization. While this context elevated abortion reform on the political agenda, legislative change did not occur. During the decision-making stage, multiple legislative proposals circulated, and political entrepreneurs were unable to organize the parliamentary majorities required for adoption in a setting shaped by coalition government and veto players. By contrast, the IVF reform was based on a single, clearly defined policy solution originating from a citizen legislative initiative. Although formally introduced as a Senate bill, the adopted legislation closely followed the citizen proposal, providing a ready-made solution that facilitated majority-building within the governing coalition and enabled policy adoption despite preliminary objections from veto players. The study employs a qualitative two-case comparative design to examine how these differences can be explained despite similar political conditions. The analysis draws on the Multiple Streams Approach developed by John Kingdon, using the distinction between agenda-setting and decision-making stages proposed by Herweg, Huß and Zohlnhöfer. By differentiating between agenda coupling and decision coupling, the paper shows that policy success depends not only on problem salience and political change, but crucially on the availability of a dominant policy solution and the capacity of political entrepreneurs to organize parliamentary majorities under coalition government.