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Policy Sciences
Published in: Policy Sciences 2/2020

02-01-2020 | Research Article

Designing policy resilience: lessons from the Affordable Care Act

Authors: Daniel Béland, Michael Howlett, Philip Rocco, Alex Waddan

Published in: Policy Sciences | Issue 2/2020

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Abstract

Public policies are the products of political conflict, constituted by mixes of diverse tools and instruments intended to achieve multiple goals that may change over time and not always be internally consistent or coherent. Recent studies dealing with policy robustness and resilience have theorized about the temporal development of mixes of policy instruments and the need to ensure consistency and coherence over time, yet they have generally failed to develop these insights into lessons for policymakers and practitioners. Drawing on evidence from the implementation of the Patient Protection and Affordable Care Act (ACA) in the USA, this paper examines the relationship between policy mixes and policy resilience or the ability of a policy to withstand challenges to its elements and to remain effective over time, even when deliberate efforts are made to alter, adapt, or repeal all or part of its original content or intention. Although the ACA is at an early stage in its history, it provides many lessons about how, and how not, to design complex policy mixes that can survive determined political opposition.
previous article Policy feedback and pathways: when change leads to endurance and continuity to change
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Footnotes
1
The term “policy mix” is commonly used to describe both mixes of instruments in a single policy area as well as multi-sectoral or multi-issue policies composed of more than a single program or policy. Here it is used in the former sense (Rogge and Reichardt 2016; Howlett and del Rio 2015).
 
2
For a discussion of these three issues see (Cox et al. 2016).
 
3
In 2018, over half the states relied wholly on the federal government’s alternative arrangements, even though the federal government allowed states to develop hybrid state-federal models that reduced the administrative burden on states when establishing these new bodies (KFF 2018b; Jones et al. 2014a).
 
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Metadata
Title
Designing policy resilience: lessons from the Affordable Care Act
Authors
Daniel Béland
Michael Howlett
Philip Rocco
Alex Waddan
Publication date
02-01-2020
Publisher
Springer US
Published in
Policy Sciences / Issue 2/2020
Print ISSN: 0032-2687
Electronic ISSN: 1573-0891
DOI
https://doi.org/10.1007/s11077-019-09368-w

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