case study of coalition government

Policy Brief 46: Improving Coalition Governance

By William Gumede

Although many coalition governments at the local level have failed, coalition governance, as a form of government, has now become part of the political system of South Africa. Coalition governments, which involve multiple political parties governing collaboratively, are prominent in more than 40 countries and are a significant form of governance globally.

Since the end of colonialism in the post-Second World War period, it has been the most successful form of government in Africa’s modern history. Of the 54 Africans, the two most successful African countries – in terms of peace, economic prosperity, and inclusivity, apart from Botswana, Mauritius and Cape Verde, for the past 100 years, have been governed by coalitions (Kadima 2006; Gumede 2017). Therefore, any argument that coalition governance results in instability, incoherent delivery and division is misinformed.

Fears that coalitions will bring instability, paralysis, and service delivery failures, are misplaced, as coalition governments, for South Africa, one of the most diverse nations on earth, are more fit for purpose than dominant-party governments. Coalition governance is particularly beneficial in ethnically, regionally, religiously, politically diverse and low-trust societies. In such diverse countries as in the case of South Africa, governing parties must be inclusive of all political, ethnic, language, regional and local differences. Often, coalition governance does this better than monopoly parties (Kadema, 2006; Gumede, 2017). All of South Africa’s coalitions in the post-apartheid era were formed after elections when none of the political parties received an outright majority.

Coalition governance is even more appropriate in diverse societies

Effective coalition governments boost oversight of government management as individual coalition partners hold each other accountable for public service delivery. The coalition may therefore be a governance oversight structure over the management of government affairs under the coalition. Coalition partners may be more keen to be responsive to their partners’ criticisms of poor delivery, corruption and dishonesty.

Coalition governance allows for the greater participation of minorities in governance; it helps cater for the interests of all groups in a country and for the adoption of policies that cater for marginalised constituencies, as dominant governing parties often only deliver to their own constituencies and exclude the interests of non-supporters.

Furthermore, because coalition governance forces participants to engage with each other regularly, get to know the other side, and build relationships, if done effectively, it is a good institution to build trust across political, racial, and class divides.

Effective coalition governance demands compromises for the greater good of public service delivery and the participation of all partners and parties governing in the interests of all the constituencies of the partnership. Successful coalition governance culture also transplants to the rest of society – making diverse societies more open to compromise, looking after the interests of all communities and stakeholders and encouraging a culture of conflict resolution. This means that coalition governance is likely to lead to more peaceful societies.

Most African countries are exceptionally diverse – ethnically, religiously, and linguistically – because of the way former colonial powers arbitrarily drew boundaries. However, since the end of the independence from colonialism, white-minority regimes and apartheid, most African countries have been run by dominant liberation and independence movements, military and personal regimes which often had their power base in one ethnic, religious, language or regional group.

They invariably governed only for their ‘own’ group rather than in the broadest interest of all communities in their respective countries. Furthermore, when most African countries launched multiparty regimes, they adopted ‘winner-takes-all’ electoral systems in which the party or leader that wins governs only for their ‘constituencies’ and excludes everyone else from the state, private sector, and societal positions. This has been among the main reasons for development, state, democratic, and economic failures in post-independence Africa. Coalition governments would have been a much more inclusive form of governance for our continent.

Coalitions critical in countries recovering from conflict

Coalition governments can either be established when no party secures a majority, or they can be formed when one party gains a majority but includes the losing parties in the form of a government of national unity (GNU). Coalitions can also be formed pre-election – before the parties have taken part in an election or post-election, based on the election results.

Coalitions have been particularly successful in countries rebuilding after war, ethnic conflict, and civil war. Following defeat in the Second World War, Germany had long periods of coalition governance, as parties spanning ideological and religious divides worked together to rebuild the country, foster national unity and boost industrial recovery. In fact, in the post-Second World War period, Germany was only governed for one term by a single party (Martin, 2017). The great German post-Second World War growth miracle happened under coalition governments.

Following the civil war in 1918, between socialists and those who opposed socialism, Finland had continuous coalition governments, often between parties with opposite ideological outlooks (Tornudd, 1969). The civil war was conducted between the Finnish Socialist Workers’ Republic (Red Finland) and the non-socialists (White Finland), during the country’s transition from being part of the Russian Empire, to an independent state. The coalition governments helped the country bind together again after the violent divisions of civil war.

In Brazil, it took coalitions of parties to band together to push out military rulers and restore constitutional rule (Mainwaring, Meneguello and Power 2000). Following a long period of military rule, a coalition government took power following the 1945 elections, with the Social Democratic Party (Partido Social Democrático), founded by Getúlio Vargas in alliance with the Brazilian Labour Party (PTB) forming the PSD-PTB alliance, which governed Brazil between 1946 and 1964 before the military staged another coup in 1964. The PSD-PTB governing alliance prioritised restoring constitutional order following military rule.

A coalition between the Brazilian Democratic Movement Party (PMDB) and the Liberal Front Party (PFL) took power under José Sarney between 1985 and 1990 following the collapse of military rule and formed the first civilian government since 1965. The PMDB-PFL governing coalition restored democracy.

Former South African President Nelson Mandela presided over a Government of National Unity, a form of coalition government, to promote reconciliation, inclusiveness, and participation, when he included all the other major opposition parties in government, including the National Party, the former apartheid governing party, and the Inkatha Freedom Party despite the fact that the ANC won the 1994 elections outright (Gumede, 2005).

Zimbabwe had a GNU at independence in 1980. Zimbabwean President Robert Mugabe, at the time, offered portfolios to the rival liberation movement, the Patriotic Front, and positions to former members of Ian Smith’s white-minority government. Mugabe’s then-Zimbabwe African National Union won 57 out of 100 parliamentary seats in the 1980 election. However, they signed a coalition agreement with the opposition Patriotic Front of Joshua Nkomo and with the Rhodesian Front, formerly a white governing party led by Ian Smith (Ross, 1980). In February 2009, Mugabe’s Zanu-PF formed a GNU with Morgan Tsvangirai’s Movement for Democratic Change and Arthur Mutambara’s faction of the MDC.

Coalitions in post-independence Africa  

Botswana’s opposition parties have forged coalitions ahead of national elections. In 2003, the Botswana National Front, Botswana People’s Party and the Botswana Alliance Movement signed a Protocol of Election Pact ahead of the 2004 national elections. They agreed to avoid vote-splitting. The protocol left out the duration of the coalition. The Botswana opposition in 2005 signed an inter-election pact, an agreement covering by-elections between major elections. The inter-election pact involved the BAM, BNF and the Botswana Congress Party, a breakaway from the BNF. The inter-election pact stipulated that the agreement was a temporary measure between the elections.

Ahead of the 2022 national elections in Angola, the National Union for the Total Independence of Angola (UNITA) formed an opposition party alliance called the United Patriotic Front under the leadership of Adalberto Costa Júnior. The coalition came within a whisker of winning the election against the country’s long-standing liberation movement government of, the People’s Movement for the Liberation of Angola (MPLA), led by incumbent President João.

In Mauritius, a coalition of several opposition parties, called L’Alliance Lepep, led by the  Mouvement Socialiste Militant (MSM) with other parties, including the  Parti Mauricien Social Démocrate (PMSD)  and the  Muvman Liberator (ML) , won the 2014 elections. Then 84-year-old Anerood Jugnauth led the L’Alliance Lepep. They won against the PTR – MMM  alliance under  Navin Ramgoolam . L’Alliance Lepep leader, the then 84-year-old Anerood Jugnauth, became prime minister in the Indian Ocean island nation. L’Alliance Lepep coalition won against a coalition led by the outgoing Prime Minister Navinchandra Ramgoolam’s Labour Party (PTR) and the Mauritian Militant Movement (MMM) of Paul Berenger.

In 2016, seven of The Gambia’s opposition parties, for the first time, united and formed an alliance called Coalition 2016 under the leadership of Adama Barrow, the leader of the United Democratic Party (UDP), then the largest opposition party, to take on the long, violent dictatorship of Yahya Jammeh and his then ruling Alliance for Patriotic Reorientation and Construction (APRC). Jammeh seized power in a military coup in 1994.

Coalitions spanning ideological divides

Coalitions can be successful even if the partners have different ideological outlooks, policies, and stances. Switzerland has been governed by coalitions since 1959. The parties represented in the Switzerland Federal Council include such disparate ideological organisations as the Liberals (FDP/PLR), the Social Democratic Party (SP/PS), The Centre (DM/LC) and the Swiss People’s Party (SVP/UDC).

The Cabinet of German Chancellor Angela Merkel between March 2018 and October 2021 consisted of widely ideologically divergent parties, including the Christian Democratic Union, Social Democratic Party, and the Christian Social Union in Bavaria. The German economy expanded dramatically, unemployment dropped, and exports boomed during the Merkel years’ multi-ideological coalition governments.

Since 1993 coalition governments have become the major form of governance in Japan. The Liberal Democratic Party (LDP) and Komeito formed a coalition government in 1999. The two parties cooperated even when they were out of government between 2009 and 2012 (Siripala, 2022). In Japan’s Diet (Japan’s legislature), seats are allocated both through single seats on an individual candidate basis and through proportional representation. As a coalition partner, Komeito would support LDP candidates in single-seat districts, and the LDP supporters would vote for Komeito in the proportional representation seats.

Former Israel Prime Minister Naftali Bennett, in 2021, put together the most diverse coalition in the country’s political history, made up of eight parties from across the political spectrum, with strong ideological differences (Berg, 2022). Bennett was from the rightwing Yamina party. The coalition also included an independent Arab party for the first time since Israel was created as a state in 1948.

Brazil’s Lula da Silva regained the presidency in October 2022 in Brazil, defeating incumbent Jair Bolsonaro through a coalition of ten parties (Pereira, 2022). The broad coalition led by Lula’s left-of-centre Workers’ Party ( Partido dos Trabalhadores ) includes political opponents united by the goal of getting Bolsonaro out of power. The coalition included the centre-right Social Democratic Party ( Partido da Social Democracia Brasileira , or PSDB), the centre-right União Brasil and the Brazilian Democratic Movement ( Movimento Democratico Brasileiro , or MDB). Lula’s vice-presidential candidate was Geraldo Alckmin, from the conservative Catholic wing (Pereira, 2022).

Why coalition governments have failed at the local level in South Africa

Coalition governments have failed in many cases in South Africa because dominant parties are not making enough compromises, smaller parties are often made to feel excluded, and coalition pacts are wrongly based on agreeing first on government positions or contracts each partner gets rather than on agreeing on a joint policy program first.

Furthermore, South Africa has so far been unable to foster a coalition governance culture – which includes parties making compromises, coalition partners giving each individual party a success story to report back to their constituency and coalition partners seeing the coalition as almost a political party on its own, that needs to be nurtured, by all the members of the coalition.

The challenge with coalitions is that they need compromises for the greater good of public service delivery, leadership maturity to rise above ego and pettiness, and self- or individual party interest Many of the leaders of parties in coalitions often lack maturity.

Many failed coalitions have not built conflict resolution mechanisms into their governance structures as part of their partnership deals. Coalitions should build a conflict resolution mechanism into their coalition agreement or as part of the coalition agreement, appoint an independent Ombud that will resolve conflicts.

Many of South Africa’s parties are built around ethnic constituencies that feel excluded, based on the past or around individuals who see their parties as their properties and their source of income. In many coalitions, the basis of the coalition partnership is allocating government positions and contracts to coalition partners. They often ‘own’ these positions, only appointing their ‘own’ members and supporters and implementing their ‘own’ policies.

This increases silos in the government’s coalitions preside over – undermining public service delivery. This is why many coalitions have not improved public service delivery. Effective delivery in any state can only happen in an integrated way rather than departments doing so in a standalone way. Furthermore, the South African state, particularly at the municipal level, has been hollowed out by corruption, mismanagement, and incompetence.

There is often no firewall between party politics and the public administration. This means that if a coalition collapses at the local level, public services often also collapse. In many mature democracies, the public administration is a professional one. And if coalitions collapse, the business of government continues uninterrupted.

Because coalitions are wrongly based on distributing positions or contracts to participating members, they do not prioritise putting together a policy program for the coalition based on the collective input of all the parties, while dominant parties in the coalition often wrongly insist on implementing their policies.

Coalition governments must put together a coalition policy platform based on the shared inputs of all partners, almost creating an entirely new policy program, which is not an individual party program, but a collective coalition program. Coalition partners – and the coalition itself, must transparently explain coalition policies to their constituencies and report back on their achievements.

Many coalitions struggle to manage the asymmetry of power in the coalition between parties with more voters and those with a lower voter base. Bigger parties often want to dominate coalition proceedings because of their voter strength. Yet, the recipe for success is for bigger parties to be seen by smaller parties to make more compromises for smaller parties.

Some parties opposing opposition-led local government coalitions often deliberately plot to bring down the government. Some opposition leaders wrongly believe that opposing a governing opposition-led government means collapsing it, which should not be the case. Many others, within and outside, deliberately attack coalition government as a form of governance, either out of ignorance or to sway voters not to vote for smaller parties. They wrongly create public sentiment against coalition governments.

Coalition governance, as a form of government, has now become part of the political system of South Africa. In theory, coalition governance is particularly useful in ethnically, regionally, religiously, and politically diverse and low-trust societies. However, in practice, it has often not worked effectively at the local level in South Africa, because parties have been unwilling to make compromises, put together joint policy programs and find amicable ways to resolve conflicts. For another, parties opposing opposition-led local government coalitions often deliberately bring down these governments under the misguided notion that to oppose a governing coalition means bringing down a government mid-election.

Yet, in the post-independence period in Africa, coalition governments have produced the highest economic growth rates, inclusive development, and peace. In many mature democracies, such as Germany, Switzerland, and Finland, it has produced stability, economic prosperity, and rapid industrialisation. However, coalitions have often failed in many other countries for similar reasons to South Africa. Ultimately, in South Africa, the failure of many coalitions is not coalition as a form of governance but how they are structured, managed, and nurtured.

Prof William Gumede acts as the independent Chair of the Multiparty Charter for South Africa in his personal capacity as an independent consultant.

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Golder, Sona Nadenichek (2006b). ‘Pre-Electoral Coalition Formation in Parliamentary Democracies’.  British Journal of Political Science  36(2):193–212

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Understanding Coalition Governments: Dynamics, Advantages, and Challenges

In the landscape of modern politics, coalition governments have become a significant phenomenon, especially in parliamentary democracies. The necessity of coalition governance arises when no single party secures a majority in the legislature, compelling parties to collaborate to form a stable government. This system offers a multifaceted approach to governance, incorporating diverse ideologies and ensuring broader representation. However, it also brings its own set of complexities and challenges. This blog delves into the essence of coalition governments, exploring their formation, functioning, benefits, and potential drawbacks.

Formation of Coalition Governments

Coalition governments are typically formed when electoral outcomes are inconclusive, and no single party can claim an outright majority. The process involves extensive negotiations among political parties to reach an agreement on shared governance. Key elements of forming a coalition include:

• Negotiation and Compromise: Parties must negotiate terms, policies, and ministerial positions. This often involves compromise, as parties need to reconcile their different manifestos into a cohesive policy agenda.
• Coalition Agreements: These are formal agreements that outline the shared goals and policy priorities of the coalition partners. They serve as a roadmap for governance and help in minimizing conflicts.
• Power-Sharing Arrangements: Positions of power, including key ministerial roles, are distributed among coalition partners based on their relative strength and contributions to the coalition.

Functioning of Coalition Governments

Once formed, a coalition government operates through collaborative decision-making processes. This can involve:

• Collective Responsibility: All coalition partners are collectively responsible for the decisions made by the government. This principle ensures that all parties support the agreed-upon policies publicly, even if there were disagreements during internal discussions.
• Cabinet Committees: To streamline decision-making, coalition governments often rely on cabinet committees where representatives from each coalition party discuss and resolve policy issues before they reach the full cabinet.
• Regular Consultations: Continuous dialogue between coalition partners is essential to maintain unity and address emerging issues. Regular consultations help in managing differences and ensuring that all parties feel heard and represented.

Advantages of Coalition Governments

Coalition governments offer several benefits that can enhance democratic governance and stability:

• Broad Representation: By involving multiple parties, coalition governments ensure that a wider array of views and interests are represented. This can lead to more comprehensive and inclusive policy-making.
• Moderation of Policies: The need for consensus among diverse coalition partners often results in more moderate and balanced policies, as extreme positions are tempered through negotiation and compromise.
• Political Stability: In countries with fragmented political landscapes, coalition governments can provide stability by uniting various factions and reducing the likelihood of political deadlock or frequent elections.
• Checks and Balances: The presence of multiple parties in government can act as a check on any single party’s power, reducing the risk of authoritarianism and encouraging transparency and accountability.

Challenges and Drawbacks of Coalition Governments

Despite their advantages, coalition governments also face significant challenges:

• Policy Gridlock: The need for consensus can sometimes lead to policy gridlock, where conflicting interests prevent the government from making decisive and timely decisions.
• Internal Conflicts: Differences in ideology and policy priorities among coalition partners can lead to internal conflicts, undermining the government’s effectiveness and cohesion.
• Short-Termism: Coalition governments may focus on short-term compromises to maintain unity, potentially neglecting long-term strategic planning and reforms.
• Voter Disillusionment: If coalition partners fail to deliver on their promises or are seen as too compromising, it can lead to voter disillusionment and a decline in public trust in the political system.

Case Studies of Coalition Governments

Several countries provide interesting case studies on coalition governance, each illustrating different aspects of its operation and impact.

• Germany: Known for its stable coalition governments, Germany’s system often involves alliances between major parties like the Christian Democratic Union (CDU) and the Social Democratic Party (SPD). The German model emphasizes meticulous coalition agreements and structured negotiations, contributing to stable governance and economic success.
• India: With its multiparty system, India frequently witnesses coalition governments at both the national and state levels. The National Democratic Alliance (NDA) and the United Progressive Alliance (UPA) are examples of major coalitions that have governed the country. The Indian experience highlights the challenges of managing diverse regional and ideological interests.
• Italy: Italian politics is characterized by frequent changes in coalition governments, reflecting the country’s fragmented party system. This volatility often results in short-lived administrations and underscores the difficulties in achieving sustained political stability through coalitions.

Coalition governments are an integral part of the political framework in many democracies, offering a pathway to inclusive and representative governance. Their ability to bring together diverse political forces can lead to more balanced and moderate policies, fostering political stability in fragmented societies. However, the inherent challenges of policy gridlock, internal conflicts, and voter disillusionment require careful management and robust mechanisms for negotiation and compromise.

Ultimately, the success of coalition governments hinges on the willingness of political parties to work collaboratively, prioritize the national interest over partisan agendas, and engage in constructive dialogue. By navigating the complexities of coalition politics, governments can harness the strengths of diverse perspectives and deliver effective governance that resonates with a broad spectrum of the electorate.

#uswc coalitiongovernment #politics #democracy #parliamentarysystems #politicalparties #negotiation #compromise #policymaking #broadrepresentation #politicalstability #governance #Germany #India #Italy #voterdisillusionment #policygridlock #internalconflicts #powersharing #coalitionagreements #cabinetcommittees #collectiveresponsibility

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Coalition Government and Party Mandate: How Coalition Agreements Constrain Ministerial Action

• Catherine Moury
• Published 11 September 2012
• Political Science

47 Citations

Cabinet formation and coalition governance: the effect of portfolio allocation on coalition agreements, beyond the water’s edge: how political parties influence foreign policy formulation in belgium, policy polarisation in italy: the short and conflictual life of the ‘government of change’ (2018–2019), wary partners, the presidential logic of government formation in latin american democracies, who decides coalition governance and ministerial discretion, let’s just agree to disagree: dispute resolution mechanisms in coalition agreements, legislative pledges and coalition government, catherine moury, coalition government and party mandate: how coalition agreements constrain ministerial action, reviewed by helene helboe pedersen, who makes a compromise adopting pledges in czech coalition agreements, related papers.

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Coalition Politics and Government Formation

Coalition politics and government formation.

Introduced by Veronica Anghel*.

Multi-party systems lead to coalition governments and with increasing polarization, coalitions are getting harder to form.  Just look at the current situation in Belgium, Italy or Spain.  The challenge is to understand what ‘harder’ means in terms of the interests, bargaining tactics, and payoffs that are in play. The vast and growing literature on coalition formation is the place to look in finding the answers. The editorial team at Government & Opposition is committed to secure ample space for contemporary debates on coalition governments. There is much to learn, understand, and predict about current affairs by looking at coalition formation and termination patterns.  Coalition politics provide important indicators of parties’ ability to compromise and form consensus. The resilience and adaptability of institutional design is critical as political elites increasingly decouple their self-interest from the public interest under the guise of populist rhetoric. This is a special collection of articles that deal with the complexities of coalition administration and the impact these have on government and society.

Coalition payoffs are the end goal of negotiations. Whether policy or office, parties aim for benefits in exchange for supporting a government. Matt Evans shows how formateur parties have an edge in obtaining policy-salient ministerial payoffs, while non-formateurs have an advantage in securing policy-salient deputy (junior) minister positions. The results are not always intuitive.  The highly coveted role of foreign minister is usually distributed to cabinet members from the larger party, and yet there are instances when this office is gained by junior coalition members.  Kai Oppermann and Klaus Brummer show the conditions under which the foreign ministry is likely to be allocated to a ‘junior coalition partner’ .

The success of negotiations assumes of course that the parties are willing to come to an agreement.  Not all political parties negotiate in good faith, however, and so make demands that the others cannot tolerate.  Keeping the wolf from the door, in this context, may be the priority for bargaining.  When different sized parties fail to reach common ground in negotiations or there is a consensus reached to leave out extremists, the two largest parties in a parliamentary system may consider the solution to engage in a ‘grand coalition’. By comparing the use of grand coalitions in Austria and Germany , Wade Jacoby investigates the conditions for success of this strategy to rally the party system against insurgent populist challengers. Jacoby also looks at the prospects for failure when this strategy is deployed too often or relied upon too heavily.

Very often, coalition negotiations also lead to the formation of minority governments. Veronica Anghel and Maria Thurk examine the rationality behind this choice.  This is where the question of interests comes into play.  Anghel and Thurk suggest that that ethno-regional parties are mostly policy-seeking and target benefits for their specific groups , while mainstream parties make stronger claims for office distribution. This diversity of interests affects other types of parties as well.  For example, Kate Crowley and Sharon Moore also expose green parties as mostly policy seeking when supporting minority governments and observe that repeat instances of such support can provide the basis for more stable and effective future interparty governing relationships.

The range of interests in play tends to increase with the number of parties and the range of political ideologies added into the mix.  Unsurprisingly, therefore, the European Parliament emerges as an extreme case.  This is not to suggest that the EP cannot function as a parliament, but rather that coalition building in the European Parliament may prove to be an ongoing and continuous process.  Daniel Finke and Annika Herbel show what this means in a legislative context by exploring the ways in which European Union policies may be affected by party groups co-sponsorship of position papers .

Coalition bargaining is a central concern in the study of Government & Opposition .  As research keeps pace with ongoing developments, we hope you will consider joining the conversation. The submission tab is located just under the search window on our home page .

Analysing Payoff Salience in Coalition Allocation: Ministers, Deputy Ministers and Committee Chairs

• Government and Opposition , Volume 55 , Issue 3

Who Gets What in Foreign Affairs? Explaining the Allocation of Foreign Ministries in Coalition Governments

• Kai Oppermann , Klaus Brummer
• Government and Opposition , Volume 55 , Issue 2

Grand Coalitions and Democratic Dysfunction: Two Warnings from Central Europe

• Wade Jacoby
• Government and Opposition , Volume 52 , Issue 2

Under the Influence: Pay-Offs to Legislative Support Parties under Minority Governments

• Veronica Anghel , Maria Thürk
• Government and Opposition , Volume 56 , Issue 1

Stepping Stone, Halfway House or Road to Nowhere? Green Support of Minority Government in Sweden, New Zealand and Australia

• Kate Crowley , Sharon Moore
• Government and Opposition , Volume 55 , Issue 4

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It’s not ordinarily a good sign when a party that governs from the (more-or-less) centre becomes mired in disillusion , and then loses more than a quarter of its support to a newly formed ethno-populist outsider . But over the past three decades South Africa has repeatedly managed to avert disaster. Apartheid was defeated; predatory ethno-populism has been contained. Perhaps the country’s propensity to snatch victory from the jaws of defeat may be surfacing yet again.

For this to happen, restraint rather than boldness is likely to be key.

I’ve spent the past three decades working to find ways to achieve development gains in the midst of governance messiness – globally, as part of a team in the World Bank (my 2014 book Working with the Grain summarises lessons learned from that experience), and then at the University of Cape Town’s Nelson Mandela School of Public Governance (where I was the founding academic director) and Johns Hopkins University’s School of Advanced International Studies.

These experiences give me optimism that, once the immediate political jockeying is done, South Africa has enormous potential for a very rapid economic turnaround.

Fragility at the centre isn’t new

On the surface, what happened in South Africa’s election is straightforward. About 15% of the electorate turned away from the ruling African National Congress (ANC), led by Cyril Ramaphosa , and voted instead for a party begun only a few months ago by the disgraced (though, of course, not in the eyes of his supporters) former president, Jacob Zuma .

Because the ANC lost its majority, it now needs to govern by coalition. Since 1997, South Africa’s experience of this mode of governance has been limited to sub-national levels, and doesn’t inspire confidence. To realise the potential of the moment, the country needs to move beyond a political culture where false certainties abound.

At first glance, the new coalition is hardly a recipe for political stability and policy coherence. The loyal leadership centre surrounding Ramaphosa will continually have to navigate between its left wing’s discomfort with the new arrangements (the Communist Party and the Congress of South African Trade Unions remain part of the African National Congress alliance), and threats to exit from some of the coalition partners.

But fragility at the centre of government is hardly a new phenomenon. As a South Africa-focused chapter of a new book on political settlements underscored, even without formal coalition government the coherence of South Africa’s political settlement has been on the decline since the late 2000s.

More important, this lack of coherence need not prevent a virtuous spiral from taking hold.

A virtuous spiral

Debates about how to get an economy moving generally focus on policy reforms. However, as economists John Maynard Keynes and Albert Hirschman taught , in the short term the most potent drivers are not so much policy as people’s ideas of what the future holds.

In a 2021 piece written for UNU-WIDER I spelled out how optimistic ideas can reinforce each other to fuel a virtuous spiral – and, correspondingly, how pessimistic ideas can set in motion a vicious, downward spiral. The piece explored the interactions among four drivers:

Driver #1: whether political and economic elites view themselves as engaging in zero-sum contestation over how to share a fixed pie – or whether they are prepared to co-operate to create new value, and share the benefits.

Driver #2: whether the country’s citizens see the political, policy and institutional environment – the power and rules that govern their lives – as legitimate.

Driver #3: whether private investors are optimistic or pessimistic about the future.

And (as influenced by each of the above):

• the strength of political leadership’s decision-making authority.

South Africa’s experience demonstrates powerfully how these drivers can be mutually reinforcing – for good or bad.

The first 15 years of democracy showed how a virtuous spiral could build momentum. Co-operation among elites, hope among the populace at large and effective leadership led to an uptick in private investment and an acceleration of growth. In time, though, the “miracle” faded.

Many lost hope in the promise of a better future. In the 2010s, things went into reverse – fractious politics, civic disillusion, cynical leadership and economic stagnation became the order of the day. A vicious downward spiral seemed to be taking hold.

Now, after the electoral surprises, a new dawn of hope may be possible.

Hope is a fragile flower

Less is more – for now. Hope is a fragile flower. Here, drawing on lessons I have learned over the past three decades, are three pointers that might help it to thrive.

First, the real world is forgiving of “good enough” policies that fall short of perfection. And despite the continual drumbeat of criticism, South Africa’s economic policy regime is “good enough” to support growth.

Macro-management has consistently been solid. And Operation Vulindlela – an initiative aimed at modernising and transforming electricity, water, transport and digital communications – has been one of the unheralded successes of Ramaphosa’s first term. It has been unblocking a variety of structural constraints to renewed growth (in part by making major inroads into the electricity crisis .)

The ANC’s decision to govern in partnership with the centre-right , and to keep its distance from the more predatory and ethno-populist segments of South Africa’s political landscape, is a new and unambiguous signal of its commitment to fostering rapid growth.

Second, while South Africa’s new coalition government could hardly be more disparate ideologically, its participants are united by a shared commitment to a thriving future for South Africa, and a shared sense that this will require a capable state.

Nevertheless, the zone of agreement between the coalition members is small. Outside that zone, the potential for bitter disagreement is huge. Push too hard and things could easily fall apart.

So, for the next two years or so, the urgent task is to focus on shared goals, and to avoid the kinds of policy and power conflicts that can turn hope into rancour, recrimination and enmity.

What are these shared goals?

Getting growth going. Strengthening the foundations of public institutions. Improving public sector performance. Focus on these – and do so in the spirit of “good enough”.

But third, as South Africa has learned, a new beginning doesn’t last forever. For a few years, the 70% or so of South Africa’s population that live in – or near the edge of – poverty may join in the optimism that can come from an economy that is on the move, and a public sector that is performing better.

But at some point South Africa’s harsh structural reality – the realisation that it will take more than a rising tide to lift all – will again re-assert itself. And it will be time to take on the more difficult questions of how to simultaneously sustain economic dynamism, do more to reduce extreme poverty, and create new opportunities for upward mobility.

But not yet. Not for the next year or two. Now is the time to build momentum – to give a new season of hope a chance to take hold.

Written by Brian Levy , Professor of the Practice of International Development, Johns Hopkins University

This article is republished from The Conversation under a Creative Commons license. Read the original article .

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32 Coalition Theory and Government Formation

Kaare W. Strøm is Distinguished Professor of Political Science at the University of California, San Diego.

Benjamin Nyblade is Assistant Professor of Political Science at the University of British Columbia, Canada.

• Published: 02 September 2009
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This article tries to show how bargaining theory has helped people understand key aspects of government formation. It also shows how people's understanding of coalition bargaining has slowly moved past the simplistic assumptions of the first generations of such theories. The article examines three specific questions in detail, and then considers the factors that influence whether specific parties or types of parties obtain government membership.

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Reconsidering coalition theory: A set theoretical assessment of government formation in Liechtenstein and Malta

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• Sho Niikawa &
• Andreas Corcaci  

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This article clarifies characteristics of the political decision-making system in Liechtenstein and Malta. Particularly, we focus on two government forms, one of which aims at securing consensus and the other at competition, while building upon a coalition theory perspective. Coalition theory as a research tradition within comparative politics provides an explanation of government formation based on individual political parties’ motivations. However, grasping different government forms from this perspective is difficult, because it features a theoretical framework for consensual governments that poses the research question of why political parties do or do not seek to form government with a simple majority. This is the question of oversized coalitions and its various models that take into account structural as well as institutional factors.

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Niikawa, S., Corcaci, A. (2016). Reconsidering coalition theory: A set theoretical assessment of government formation in Liechtenstein and Malta. In: Wolf, S. (eds) State Size Matters. Springer VS, Wiesbaden. https://doi.org/10.1007/978-3-658-07725-9_3

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General Election 2024 and Coalition Government

• 06 Jun 2024
• 12 min read
• GS Paper - 2
• Indian Constitution
• Issues Related to Women

For Prelims: Coalition government , Economic reforms , Federal system , Fiscal Responsibility & Budget Management (FRBM) , PM Gram Sadak Yojana , Information Technology Act, 2000 , Right to Education Act , Right to Information Act , Right to Food , Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) , Aadhaar, GST

For Mains : Merits and Demerits of coalition government , Challenges of coalition governments

Why in News?

Recently, for the first time since 1962 , a government has returned for a third term after completing two consecutive terms spanning a decade.

• However, the result signifies the end of single-party dominance and heralds the return of a true coalition government at the Centre.

What is a Coalition Government?

• Coalition government is defined as when several political parties j oin hands to form a government and exercise political power based on a common agreed programme.
• Coalitions usually occur in modern parliaments when no single political party gets clear majority.
• If several parties with a majority of elected members can agree on a shared plan without compromising too much with their policies, they can form a government.
• Pragmatism and not ideology mark of coalition politics.
• Coalition politics is not a static but a dynamic affair as coalition players and groups dissolve and form new ones.
• A coalition government works based on a minimum programme, which may not satisfy aspirations of all the members of the coalition government.
• The pre-poll coalition is considerably advantageous because it provides a common platform for the parties to woo the electorate based on a joint manifesto.
• The post-election union is intended to enable constituents to share political power and run the government.

Recommendations of Punchhi and Sarkaria Commission on Coalition

• The party or combination of parties which commands the wide support in the Legislative Assembly should be called upon to form the Government.
• If there is a pre-poll alliance or coalition, it should be treated as one political party and if such coalition obtains a majority, leader of such coalition shall be called by the Governor to form the Government.
• The group of parties which had pre-poll alliance commanding the largest number
• The largest single party staking a claim to form the government with the support of others
• A post-electoral coalition with all partners joining the government
• A post-electoral alliance with some parties joining the government and the remaining including independents supporting the government from outside
• It was found that the interstate council worked whenever regional political parties had a major role to play at the national level. This signifies the role of coalition government in which regional parties plays an important role.

Other Development in 2024 General Election

• India has elected 74 women MPs to Lok Sabha in the 2024 general election four less than in 2019 and 52 more than in India’s first elections in 1952.
• These 74 women make just 13.63% of the elected strength of the Lower House compared to 46% of MPs in South Africa, 35% in the UK, and 29% in the US.
• Indira Gandhi has been India’s first and only woman Prime Minister.
• This is the highest-ever NOTA number for any Lok Sabha constituency ever.
• The NOTA option was introduced for the first time in the general elections in 2014.
• In Haryana, NOTA has been treated as a fictional candidate.

What are the Merits and Demerits of the Coalition Government?

• A coalition government brings together different parties to make decisions that are balanced and satisfy interests of various stakeholders.
• India's diverse cultures, languages, and groups make coalition governments more representative and reflective of popular opinion than single-party governments.
• Coalition politics strengthens India's federal system by being more attentive to regional needs than a single-party government.
• They are unstable because disagreements on policy issues among coalition partners can cause the government to collapse.
• In a coalition government, the Prime Minister's authority is restricted as they must consult with coalition partners before making significant decisions.
• The Steering Committee, like a 'Super-Cabinet' for coalition partners, diminishes the authority of the cabinet in governing.
• Smaller parties in a coalition government might have significant influence by demanding more than their fair share of power in Parliament.
• Leaders of regional parties influence national decisions by advocating for issues specific to their regions, exerting pressure on the central government to align with their interests under the threat of coalition withdrawal.
• In a coalition government, the Council of Ministers tends to be larger due to the interests of all major parties in the coalition.
• In coalition governments, members often avoid taking responsibility for mistakes by blaming each other, thus avoiding both collective and individual accountability.

What has been the Role of Coalition Governments in Reforms?

• Since 1991, India experienced coalition governments where the leading party was far from the majority mark of 272.
• Coalition governments have implemented some of the boldest economic reforms in India’s history.
• Economic Liberalisation (LPG Reforms): Liberalised the economy by removing the licence-permit raj and embraced global competition.
• WTO Membership: India became a member of the World Trade Organisation , integrating more deeply into the global economy.
• Dream Budget: Finance Minister was known for reducing tax rates, and fostering a more favourable economic environment for taxpayers and businesses.
• Fiscal Responsibility & Budget Management (FRBM) Act: Introduced fiscal discipline by limiting government borrowing.
• Disinvestment and Infrastructure: Pushed for disinvestment of loss-making PSUs and improved rural infrastructure through schemes like the PM Gram Sadak Yojana.
• Information Technology Act, 2000: Laid the groundwork for the booming e-commerce sector in India.
• Rights-Based Reforms : Various reformative measures were brought in like the Right to Education Act, the Right to Information Act , the Right to Food , and the Mahatma Gandhi National Rural Employment Guarantee Act (MG-NREGA) .
• Economic Deregulation: Deregulated fuel prices, initiated direct benefit transfers, and worked on the Aadhaar and GST systems.
• Despite the inherent challenges , coalition governments offer a platform for diverse voices and can foster consensus-driven policies.
• A well-functioning coalition, built on a foundation of mutual respect, strong leadership, and a commitment to national progress, can navigate the complexities of a vibrant democracy.
• The report suggested it would be best if all governments in India, at all tiers, mandatorily accomplish a 50-plus vote share.
• With this recommendation, Justice Venkatachaliah meant that only a government with a 50-plus % vote share would have the necessary legitimacy to govern.

UPSC Civil Services Examination, Previous Year Question (PYQ)

Q. With reference to Deputy Speaker of Lok Sabha, consider the following statements: (2022)

• As per the Rules of Procedure and Conduct of Business in Lok Sabha, the election of Deputy Speaker shall be held on such date as the Speaker may fix.
• There is a mandatory provision that the election of a candidate as Deputy Speaker of Lok Sabha shall be from either the principal opposition party or the ruling party.
• The Deputy Speaker has the same power as of the Speaker when presiding over the sitting of the House and no appeal lies against his rulings.
• The well-established parliamentary practice regarding the appointment of Deputy Speaker is that the motion is moved by the Speaker and duly seconded by the Prime Minister.

Which of the statements given above are correct?

(a) 1 and 3 only

(b) 1, 2 and 3

(c) 3 and 4 only

(d) 2 and 4 only

Q. To what extent, in your view, the Parliament is able to ensure accountability of the executive in India? (2021)

Q. How far do you think cooperation, competition and confrontation have shaped the nature of federation in India? Cite some recent examples to validate your answer. (2020)

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AP the best case study for political executive and administrators

Some of the All India Services officials are now blaming the previous government of having pressurised them and threatening them to follow what the political executive says. Well this argument is rather untenable. There is no reason for the administration to have got so much paralysed

The attention of the country is now on Andhra Pradesh which has a three-party alliance consisting of TDP, Jana Sena and BJP. The NDA alliance government in Andhra Pradesh has a series of challenges ahead of it which includes construction of Amaravati and completion of Polavaram project and reorganizing the administration.

Chandrababu Naidu has to establish that the alliance government has clear priorities and would not deviate from the promises it had made to the people and will not fall into the trap of self-styled intellectuals or the campaign which YSRCP would soon be taking up saying that TDP despite being in a position to claim its pound of flesh from centre was silent on special status.

While keeping itself aloof from such traps, the Andhra Pradesh government has the responsibility of streamlining the administration without showing vindictive attitude towards the All India Services officials though they have crossed the Laxman Rekha every time in the last five years which led to serious damage to the state in every respect including its brand image.

An example how Naidu has demonstrated his statesmanship quality in administration can be seen from the way he had given a chance to some senior most IAS officials to retire with grace. The then Chief Secretary Jawahar Reddy had been facing several allegations. Everyone had seen how he had even ignored the directions of Election Commission of India in payment of social welfare pensions which had angered the people and political parties. We have seen how other institutions like the police and CID did everything the CM and his coterie wanted and unleashed a reign of terror.

Though Jawahar Reddy earned a name of being more loyal than the king, the new government first asked him to report to General Administration Department and now it had posted him as Special Chief Secretary to BC welfare.

Why? It is so because Reddy is due to retire on June 30. The government does not want to be vindictive and deprive him of his retirement benefits. It wants an honourable exit for the long service he had rendered to the state though last five years was an aberration.

Similarly, Poonam Malakondaiah has also been facing several allegations of having blindly implemented all that the YSRCP government wanted her to do. She has also been given an important post so that she too can retire honourably.

This is in contrast the to the highly vindictive attitude shown by the YSRCP government to a DGP rank IPS officer A B Venkateswara Rao. Rao was harassed without giving any posting for five years and had to face cases after cases till last date of his retirement.

This has pushed some in the party and people into confusion. They felt Naidu would be a different leader now. They are now discussing whether Naidu is a changed leader or not. They feel that the IAS officers who committed mistakes should be punished and cannot be allowed to go scot free.

Surely, he should do that but the issue here is that any government that believes in democracy cannot change all officials in one go and get 100% new team. It needs to run administration with the best of the available officers.

So there has to be a balance. Some of those facing allegations should be given not so important posts and if some are facing serious allegations, action against them should be taken as per laws for all their misdeeds.

But some of the All India Services officials are now blaming the previous government of having pressurised them and threatening them to follow what the political executive says. Well this argument is rather untenable There is no reason for the administration to have got so much paralysed.

What would happen if they don’t agree with the government’s line and refuse to do what is not correct? They will be shunted out. What more can a state government do? Why should they succumb to pressures? What were the IAS associations doing all these five years? Doubts are being cast on these associations as well.

Why they did not take up the matter with the Union Home Ministry or if they had drawn the attention of the Home Ministry or Department of Personnel did they ignore their pleas? This too needs to be made public. If so why did the Centre remain mute spectator? What was the reason?

It would be interesting if some of these officials who at least after their retirement come out with facts so that the next generation of officers who are in service can learn lessons from them and bring changes in the system. One needs to know was it just pressure and threats for the YSRCP government or was there any other reason or consideration.

There was a time when many used to come to study the good governance practices in AP and the MCRHRD institute in Hyderabad used to be the main centre where several IAS trainees and officials used to come, study and learn.

Now the situation is different. They should perhaps come and study how officials can ruin the administration if they either succumb or compromise on core values.

At the same time the statesmanship quality displayed by this alliance government should be taken as an opportunity by the former ‘Ayya Yes’ officials to repent and reform themselves and vow never to turn into slaves of political executive. They should understand that their motto should be “Dil ki Suno” (Listen to what your conscience says not what the political bosses insist).

They should not only study the books on public administration but should study how in the past IAS officers used to be the eyes and ears of the Chief Ministers and used to call a spade a spade. Of course those were the days when Chief Ministers also used to give them that kind of freedom and respect their suggestions.

Even Y S Rajasekhar Reddy, father of Jaganmohan Reddy was not averse to learn from the officials. When the ORR was being constructed, senior officials say he had held several rounds of meetings with them trying to understand the reports submitted by the officials on the design and expenditure part of the ORR. He never said, “I know or just do what I say.”

The present alliance government will certainly be a case study of how coalitions should work whether it be in States or at Centre.

• Andhra Pradesh politics
• TDP-Janasena-BJP alliance
• Nara Chandrababu Naidu
• Pawan Kalyan
• Narendra Modi
• Polavaram Project
• Administrative reorganization
• Coalition Government

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HHS Announces Cost Savings for 64 Prescription Drugs Thanks to the Medicare Rebate Program Established by the Biden-Harris Administration’s Lower Cost Prescription Drug Law

Under President Biden’s Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs if the drug’s price increased faster than the rate of inflation.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from July 1, 2024 – September 30, 2024, since each drug company raised prices faster than the rate of inflation.  Over 750,000 people with Medicare use these drugs annually, which treat conditions such as osteoporosis, cancer, and infections. White House Domestic Policy Advisor Neera Tanden will announce the cost savings on these life-saving drugs in a keynote address on the Biden-Harris Administration’s focus on lowering costs today at the Center for American Progress.

“Without the Inflation Reduction Act, seniors were completely exposed to Big Pharma’s price hikes. Not anymore. Thanks to President Biden and the new Medicare inflation rebate program, seniors are protected and benefitting from lower Part B drug costs,” said White House Domestic Policy Advisor Neera Tanden. “The Biden-Harris Administration will continue fighting to bring down the cost of health care and prescription drugs for all Americans.”

“President Biden’s Medicare prescription drug rebate program is putting money back in the pockets of seniors and people with disabilities, said HHS Secretary Xavier Becerra. “President Biden made lowering prescription drug costs for Americans a top priority, and he is delivering on that promise. Our work is not complete, and we will continue to fight for lower health care costs for all Americans.”

Please find soundbites from HHS’ Chief Competition Officer, Stacy Sanders, here .

Because of President Biden’s lower cost prescription drug law, the Inflation Reduction Act, which established the Medicare Prescription Drug Inflation Rebate Program, some people with Medicare who use these drugs during this time period may save between $1 and $4,593 per day.

“Everyone should be able to afford their medication, and the Inflation Reduction Act continues to deliver on this goal to improve affordability,” said CMS Administrator Chiquita Brooks-LaSure. “Discouraging drug companies from price increases above the rate of inflation is a key part of this effort, and CMS continues to implement the law to bring savings to people with Medicare.”

Padcev, a medication used to treat advanced bladder cancer, is an example of a prescription drug with a price that has increased faster than the rate of inflation every quarter since the Medicare Part B inflation rebate program went into effect, resulting in lowered Part B coinsurances for seniors and others with Medicare. A beneficiary taking Padcev as part of their cancer treatment may have saved as much as $1,181 from April 1, 2023 through March 31, 2024, depending on their coverage and course of treatment. Another example, Crysvita, treats a rare genetic disorder that causes impaired growth, muscle weakness, and bone pain. A beneficiary taking Crysvita may have saved as much as $765 from July 1, 2023 through March 31, 2024 depending on their coverage and course of treatment.

The Medicare Prescription Drug Inflation Rebate Program is just one of the Inflation Reduction Act’s prescription drug provisions aimed at lowering drug costs. In addition to this program, the law expanded eligibility for full benefits under the Low-Income Subsidy program (LIS or “Extra Help”) under Medicare Part D at the beginning of this year. Nearly 300,000 people with low and modest incomes are now benefiting from the program’s expansion. A comprehensive public education campaign is underway to reach the more than three million people who are likely eligible for the program but not yet enrolled.

In addition, as of January 1, 2024, some people enrolled in Medicare Part D who have high drug costs have their annual out-of-pocket costs capped at about $3,500. In 2025, all people with Medicare Part D will benefit from a $2,000 cap on annual out-of-pocket prescription drug costs.

The Inflation Reduction Act requires drug companies to pay rebates to Medicare when prices increase faster than the rate of inflation for certain drugs. CMS intends to begin invoicing prescription drug companies for rebates owed to Medicare no later than fall 2025. The rebate amounts paid by drug companies will be deposited in the Federal Supplementary Medical Insurance Trust Fund, which will help ensure the long-term sustainability of the Medicare program for future generations.

For more information on the Medicare Prescription Drug Inflation Rebate Program visit, https://www.cms.gov/inflation-reduction-act-and-medicare/inflation-rebates-medicare

To view the fact sheet on the 64 Part B drugs with a coinsurance reduction for the quarter July 1, 2024 – September 30, 2024, visit, https://www.cms.gov/files/document/reduced-coinsurance-certain-part-b-rebatable-drugs-july-1-september-30-2024.pdf

More information and helpful resources about the Inflation Reduction Act and how it is helping to lower costs for people with Medicare can be found at LowerDrugCosts.gov .

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Supreme Court Jeopardizes Opioid Deal, Rejecting Protections for Sacklers

The justices rejected a bankruptcy settlement maneuver that would have protected members of the Sackler family from civil claims related to the opioid epidemic.

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By Abbie VanSickle

Reporting from Washington

The Supreme Court said on Thursday that members of the Sackler family cannot be shielded from liability for civil claims related to the opioid epidemic, jeopardizing a bankruptcy plan that would have offered such protection in exchange for channeling billions of dollars toward addressing the crisis.

In a 5-to-4 decision, the justices found that the deal, carefully negotiated over years with states, tribes, local governments and individuals, had broken a basic tenet of bankruptcy law by shielding members of the Sackler family from lawsuits without the consent of those who might sue.

The plan for Purdue Pharma, the maker of the prescription painkiller OxyContin, the drug widely considered to have ignited the crisis, was unusual because it offered broad protections that the Sackler family, who controlled the company, had demanded for years even as the Sacklers avoided declaring bankruptcy themselves.

“The Sacklers have not filed for bankruptcy and have not placed virtually all their assets on the table for distribution to creditors, yet they seek what essentially amounts to a discharge,” Justice Neil M. Gorsuch wrote, joined by Justices Clarence Thomas, Samuel A. Alito Jr., Amy Coney Barrett and Ketanji Brown Jackson.

While he acknowledged that the decision left the plan in limbo, Justice Gorsuch wrote that the threat of future lawsuits from opioid victims, states, government entities and others might compel the Sacklers “to negotiate consensual releases on terms more favorable to opioid victims.”

“If past is prologue,” Justice Gorsuch wrote, citing the U.S. Trustee Office, which challenged the deal, “there may be a better deal on the horizon.”

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Things to know about the gender-affirming care case as the Supreme Court prepares to weigh in

FILE - A flag supporting LGBTQ+ rights decorates a desk on the Democratic side of the Kansas House of Representatives during a debate, March 28, 2023, at the Statehouse in Topeka, Kan. The U.S. Supreme Court agreed Monday to consider whether a Tennessee ban on gender-affirming care for minors is constitutional. (AP Photo/John Hanna, File)

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The U.S. Supreme Court said Monday that it will hear arguments on the constitutionality of state bans on gender-affirming care for transgender minors.

The issue has emerged as a big one in the past few years. While transgender people have gained more visibility and acceptance in many respects, half the states have pushed back with laws banning certain health care services for transgender kids.

Things to know about the issue:

What is gender-affirming care?

Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, including when it’s different from the sex they were assigned at birth.

The services are offered to treat gender dysphoria, the unease a person may have because their assigned gender and gender identity don’t match. The condition has been linked to depression and suicidal thoughts.

Gender-affirming care encompasses counseling and treatment with medications that block puberty, and hormone therapy to produce physical changes. Those for transgender men cause periods to stop, increase facial and body hair, and deepen voices, among others. The hormones used by transgender women can have effects such as slowing growth of body and facial hair and increasing breast growth.

Gender-affirming care can also include surgery, including operations to transform genitals and chests. These surgeries are rarely offered to minors .

What laws are states passing?

Over the past three years, 26 Republican-controlled states have passed laws restricting gender-affirming care for minors. Most of the laws ban puberty blockers, hormone treatment and surgery for those under 18. Some include provisions that allow those already receiving treatment to continue.

The laws also make exceptions for gender-affirming treatments that are not part of a gender transition, such as medications to stop breast growth in boys and excessive facial hair in girls.

One of the laws — in Arkansas — was nixed by a federal court and is not being enforced.

Meanwhile, at least 14 Democratic-controlled states have adopted laws intended to protect access to gender-affirming care.

The gender-affirming care legislation is a major part of a broader set of laws and policies that has emerged in Republican-controlled states that rein in rights of transgender people. Other policies, adopted in the name of protecting women and girls, bar transgender people from school bathrooms and sports competitions that align with their gender.

What have courts said so far?

Most of the bans have faced court challenges, and most are not very far along in the legal pipeline yet.

The law in Arkansas is the only one to have been struck down entirely, but the state has asked a federal appeals court to reverse that ruling.

The 6th U.S. Circuit Court of Appeals, one step below the Supreme Court, last year ruled that Kentucky and Tennessee can continue to enforce their bans amid legal challenges. The high court has agreed to hear the Tennessee case in the term that starts later this year.

The U.S. Supreme Court in April ruled that Idaho can enforce its ban while litigation over it proceeds. A lower court had put it on hold.

What does the medical community think?

Every major U.S. medical group, including the American Academy of Pediatrics and the American Medical Association, has opposed the bans and said that gender-affirming treatments can be medically necessary and are supported by evidence.

But around the world, medical experts and government health officials are not in lockstep. Some European countries in recent years have warned about overdiagnosis of gender dysphoria.

In England, the state-funded National Health Service commissioned a review of gender identity services for children and adolescents, appointing retired pediatrician Dr. Hilary Cass to lead the effort. The final version of the Cass Review , published in April, found “no good evidence on the long-term outcomes of interventions to manage gender-related distress.”

England’s health service stopped prescribing puberty blockers to children with gender dysphoria outside of a research setting, following recommendations from Cass’ interim report.

The World Professional Association for Transgender Health and its U.S. affiliate issued a statement in May saying they’re deeply concerned about the process, content and consequences of the review, saying it “deprives young trans and gender diverse people of the high-quality care they deserve and causes immense distress and harm to both young patients and their families.”

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