This paper examines the process of decision making of two policies aiming to universalize the access to health services: AUGE in Chile under President Lagos, and AUS in Peru under the García Administration. I incorporate the strength of the programmatic nature of political parties as an independent variable explaining the difference in the process of decision making and final policy outputs. The role of party leadership together with programmatic commitments is found to be important for the agenda setting process. Further, a systematic analysis of floor debates finds the presence of programmatic political parties of the left and right to lead to an exhaustive debate. Finally, the presence of programmatic political parties in Chile is found to lead to a policy with clear definitions and viable objectives, which had important implications for its further implementation. Conversely, weakly programmatic parties led to a poorly specified policy in Peru, which negatively impacted its implementation.