Many scholars argue that democratization is conducive to the development of social welfare policies and that democracy brings about redistributive reform due to demands from the newly enfranchised poor. In reality, however, democratization does not necessarily bring about comprehensive social welfare reform. If not democratization, what explains social welfare expansion in developing countries? This article examines Indonesia, which began the process of democratization in 1998 following the fall of President soeharto, and which has since become a stable democracy with a consistently growing economy. More than a decade after soeharto’s resignation, Indonesia started to implement a comprehensive healthcare policy. What explains the gap between the enactment and the implementation of this social policy reform? In answering this question, I argue that electoral competition alone does not shape social policy reform. Instead, social reform has institutional prerequisites, such as the broad-based organization of its advocates. A broad-based organization goes beyond its narrow interests, builds cross-class alliance and pressures the government. Without this prerequisite, democratization does not necessarily result in comprehensive social reforms.