If the planned reform succeeds, the Swedish “hourglass” will change, particularly at the subnational level, as a stronger county level could be a better partner for municipalities in regional development issues. The County Council’s responsibility for regional development became permanent in 2010 and at that time two additional regions received development competences. Six years later, ten more County Councils have the responsibility for regional development (including public transport and culture), on top of public healthcare. The result has been a strongly context-dependent approach to regional governance rather than a “one-size-fits-all” approach.