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Democratic transition and institutional change do not necessarily guarantee greater political inclusion, particularly when it comes to the policy influence of civil society groups. Rather, political inclusiveness requires strategic adaptation among societal actors. Actors need to seize upon opportunities endemic to political change. This article provides a comparative analysis of health care reform in democratizing Taiwan and South Korea, focusing on two social movement coalitions, the National Health Insurance Coalition in Taiwan and Korea's Health Solidarity. Both movement coalitions were critical in shaping welfare reform trajectories in Taiwan and South Korea during the late 1990s, despite having been shut out from earlier episodes of health care reform. I argue that these groups (1) strategically adjusted their mobilization strategies to fit specific political and policy contexts, (2) benefited from broad-based coalition building, and (3) effectively framed the issue of social welfare in ways that gained these movements ideational leverage, which was particularly significant given the marginal place of leftist ideas in the postwar East Asian developmental state model. [ABSTRACT FROM AUTHOR]