AbstractThis article starts with a discussion of the analytical issues of the Programmatic Action Framework (PAF); based on the hypothesis that small groups of individuals, sharing a similar analysis of a policy problem sustaining a common policy change program (including orientations, arguments, and instruments) giving them a collective identity, and behaving strategically as a collective actor, can be main drivers of policy change. We then present the methodological implications of the empirical analysis of such programmatic groups and policy change programs. The methodology of the Programmatic Action Framework combines tools coming from the sociology of elites (positional analysis, analysis of professional trajectories, relational analysis) and the sociology of the policy process. It was first applied in empirical researches on health insurance reforms in France and the United States since the 1980s, shedding the light on the key role of specialized policy elites (specialized senior civil servants in France, long‐term insiders in the United States). We conclude by stressing that, because of its systematic and encompassing empirical methodology, the Programmatic Action Framework can be used in a comparative way, in other policy sectors than health care.