Policy Feedback and the Politics of the Affordable Care Act

There is a large body of literature devoted to how “policies create politics” and how feedback effects from existing policy legacies shape potential reforms in a particular area. Although much of this literature focuses on self‐reinforcing feedback effects that increase support for existing policies over time, Kent Weaver and his colleagues have recently drawn our attention to self‐undermining effects that can gradually weaken support for such policies. The following contribution explores both self‐reinforcing and self‐undermining policy feedback in relationship to the Affordable Care Act, the most important health‐care reform enacted in the United States since the mid‐1960s. More specifically, the paper draws on the concept of policy feedback to reflect on the political fate of the ACA since its adoption in 2010. We argue that, due in part to its sheer complexity and fragmentation, the ACA generates both self‐reinforcing and self‐undermining feedback effects that, depending of the aspect of the legislation at hand, can either facilitate or impede conservative retrenchment and restructuring. Simultaneously, through a discussion of partisan effects that shape Republican behavior in Congress, we acknowledge the limits of policy feedback in the explanation of policy stability and change.     

Framing the Poor: Media Coverage and U.S. Poverty Policy, 1960–2008

Public policy toward the poor has shifted from an initial optimism during the War on Poverty to an ever‐increasing pessimism. Media discussion of poverty has shifted from arguments that focus on the structural causes of poverty or the social costs of having large numbers of poor to portrayals of the poor as cheaters and chiselers and of welfare programs doing more harm than good. As the frames have shifted, policies have followed. We demonstrate these trends with new indicators of the depth of poverty, the generosity of the government response, and media framing of the poor for the period of 1960–2008. We present a simple statistical model that explains poverty spending by the severity of the problem, gross domestic product, and media coverage. We then create a new measure of the relative generosity of U.S. government policy toward the poor and show that it is highly related to the content of newspaper stories. The portrayal of the poor as either deserving or lazy drives public policy.     

U.S. Environmental Policy Implementation on Tribal Lands: Trust,Neglect, and Justice

This study investigates the implementation of U.S. environmental protection laws under American Indian tribal governance. The landmark laws of the 1970s that form the core of America's environmental policy regime made no mention of American Indian tribal lands, and the subsequent research literature on environmental policy has given them little attention. The U.S. Environmental Protection Agency has primary implementation responsibility for environmental protection laws on tribal lands, which offers a unique opportunity to study direct federal implementation apart from typical joint state–federal implementation. Further, because Indian reservations are homes to a disproportionately poor, historically subjugated racial group, analysis of environmental programs on tribal lands offers a unique perspective on environmental justice. We analyze enforcement of and compliance with the Clean Water Act (CWA) and Safe Drinking Water Act (SDWA) to compare the implementation of environmental policy on tribal lands with nontribal facilities. Analysis reveals that, compared with nontribal facilities, tribal facilities experience less rigorous CWA and SDWA enforcement and are more likely to violate these laws.     

Latinos and Environmental Justice: Examining the Link between Degenerative Policy,Political Representation,and Environmental Policy Implementation

The theory of social construction and policy design is insightful for exploring the circumstances in which the allocation of policy benefits and burdens is attributed to the feed‐forward effect of degenerative policy that institutionalizes bias and reinforces the prevailing categorization and embedded social meaning regarding target populations. However, this theoretical framework has not been broadly adopted to analyze the environment‐related phenomena. With a nationwide, block‐group‐level sample, this study examines the extent to which degenerative policies pertaining to immigrants influence state agencies' environmental regulatory outputs for predominantly Latino communities. Results show that in the states with moderately to most restrictive immigrant policy and high levels of Latino representation in legislatures, the rigorousness of government agencies' compliance monitoring activities decreases for Latino neighborhoods of environmental justice concern, as states' policy stance toward immigrants becomes more unfavorable. More Latino elected officials do not bolster policy implementation efforts for the vulnerable communities or offset the backlash effect of immigrant policy.     

Standing in Line When Queues Are on the Decline: Services Satisfaction Following the Swedish Health Care Waiting Time Guarantee

Understanding mass public support for health systems and welfare polices is required in order to safeguard the legitimacy of democratic governance of the welfare state. If policies to meet dissatisfaction go unnoticed, the whole idea of responsive democracy is in vain. This paper focuses on the 2005 Swedish health care waiting-time guarantee, which resulted in drastically lower hospital waiting times in Västra Götaland County. Exploring questions of significant theoretical relevance in the literature about policy feedback effects, the paper investigates if the decrease in waiting times affected hospital service satisfaction and if this effect was moderated by policy proximity and visibility. Data from the West Sweden SOM survey are utilized, measuring hospital service satisfaction from 2004 to 2009. To disentangle the role of policy proximity, two indicators are used—user status and subjective health status. Furthermore, policy visibility is measured by an individual’s level of political interest. The results show that the decrease in waiting times resulted in a substantial increase in hospital service satisfaction. However, the increase was not more pronounced among groups with higher proximity and visibility. On the contrary, results indicate that the increase in hospital service satisfaction was stronger among those already in good health.     

Surfing for Problems: Advocacy Group Strategy in U.S. Forestry Policy

John Kingdon sets out a multiple streams approach to policymaking, whereby problems, solutions, and politics develop independently of one another. Kingdon's work suggests that advocates with pet policies may continually search the problem stream, looking for prominent issues to attach to their preferred solutions. I call this process "problem surfing." This paper provides an empirical test of problem surfing through the use of a case study of environmental advocacy. The paper examines Wilderness Society and Sierra Club advocacy for sustainable forestry practices from 1971 to 1994 through an analysis of articles in member magazines and interview data. Problem surfing is revealed to be a complex strategic process. I find evidence that advocacy groups adjust the problems they associate their solutions with over time to take advantage of salient issues. However, problem surfing appears to be influenced by more than just problem salience.     

Campaign Promises,Democratic Governance,and Environmental Policy in the U.S. Congress

One important criterion for assessing the quality of democratic governance is the extent to which the policy process effectively translates citizen preferences into collective choices. Several scholars have observed a discrepancy between citizen preferences for strong environmental protection and weak policies adopted in the United States, indicating that the United States may fall short on this criterion. We examine one possible mechanism contributing to this discrepancy—legislator defection from campaign promises. Our data indicate that legislators in the U.S. Congress routinely defect from their campaign promises in environmental protection, undermining the link between citizen preferences and policy choice. We also find that legislators are much more likely to defect from pro‐environmental campaign promises, which moves government policy toward less stringent environmental programs. Finally, the propensity of legislators to defect from their campaign promises is systematic, with defection affected by partisanship, constituency influence, the influence of the majority party, and the likely consequences of defection for policy choice. These findings contribute empirical evidence relevant to the “mandate theory” perspective on how citizen preferences are translated into collective choices through the policy process. These findings may also complement research in comparative politics concluding that legislatures selected through single member districts adopt less stringent environmental policies than do legislatures chosen via proportional representation in that the mechanism for this effect may go through legislator defection from campaign promises.     

对峙中的缓和：70年代的美国对朝政策

对朝鲜政策是美国亚太政策中非常重要的一环.伴随着70年代国际局势的相对缓和,美国对朝政策也出现松动.尽管两国间危机不断,但在安全、政治、文化交流等领域美国仍采取了一些主动缓和的措施.然而,作为二战后美国第一场热战的主要对手之一和意识形态上的敌人,美国对改善对朝关系又心存疑虑,同时也受到多方牵制,最终没能有所突破.     

Redistricting principles and incumbency protection in the U.S. Congress

Critics of congressional redistricting have argued that recent legislative gerrymandering severely undermines electoral competitiveness to the point of violating constitutional equal protection standards. In this paper, we assess how states' redistricting plans vary in incumbency protection. Particularly, we evaluate whether redistricting principles and processes had any measurable consequence in incumbency protection in the 2000 redistricting cycle. We first report substantial regional variation across states in the principles formally noted in state redistricting laws. We then report results showing that some traditional, “politically neutral” redistricting principles and less politicized processes significantly diminish incumbency protection. Our results indicate significant incumbency gerrymandering across states in the recent cycle; however, states have significantly less incumbency protection when they specify specific population- and politically-based principles while suppressing elected officials' agenda setting influence in the districting process.     

Agency Evolution, New Institutionalism, and 'Hybrid' Policy Domains: Lessons from the 'Greening' of the U.S. Military

Neoinstitutionalists applying the logic of rational choice institutionalism have leavened our understanding of public agency design and evolution in the domestic and national security policy domains. This paper seeks to advance theory building in empirically grounded ways by assessing the explanatory power of an important theoretical perspective (rational choice institutionalism), in an understudied "hybrid" policy domain where domestic and national security aims interact (domestic environmental policy and national security policy), and in an organizational type (the U.S. military) that has drawn scant attention from students of bureaucracy in political science, public administration, or public management. Analysis of three major efforts to green the U.S. military suggests that the patterns of politics accompanying agency evolution involving hybrid policy domains differ from domestic and national security domains in ways that limit the generalizability of rational choice institutionalism.     

Applying Policy Termination Theory to the Abandonment of Climate Protection Initiatives by U.S. Local Governments

A considerable amount is known about the factors that influence policy adoption and implementation across different issue areas. Less is known, however, about the factors that influence governments to abandon programs or policies prior to reaching their stated objectives or originally specified end‐points. This article applies termination theory to local climate protection initiatives and examines cities’ withdrawal from the dominant sustainability organization facilitating these efforts. In the face of national government inaction, large numbers of U.S. municipalities voluntarily committed to reduce their greenhouse gas (GHG) emissions and joined the ICLEI's Climate Protection program. After steady membership increases for nearly a decade, ICLEI attained its largest size in 2010 with 565 city members. Over the next 2 years, this number plummeted by 20 percent. Positioned in the literature on policy change, we empirically test three hypotheses for why a substantial portion of cities ended their affiliation with this organization and terminated the explicit climate protection objectives associated with it: (1) political ideology and interest group pressure, (2) fiscal constraints, and (3) perceived program ineffectiveness. Analytical results support the first and third hypotheses. We identify factors that influence the termination of local GHG reduction initiatives and discuss theoretical implications of these findings.     

Effects of U.S. States' Social Welfare Systems on Population Health

Social scientists have studied the welfare state extensively. Many studies seek to understand the determinants of the welfare state; however, a few have explored the social consequences of social welfare systems, especially on health outcomes of the population. Even though cross-national comparative studies support the thesis that the welfare state regime type, which represents different levels of commitment on social welfare, is closely linked to population health, there is little research to support this argument at a sub-national level. To fill the gap, this study explores the effects of the U.S. states' social welfare systems on health using age-adjusted mortality rates as a proxy for population health. By operationalizing social welfare systems as three dimensions—public expenditures, tax structures, and welfare program rules—we find that more generous education spending, progressive tax systems, and more lenient welfare program rules help to improve population health. The model corrects for first-order serial correlation using Prais-Winsten regression methods and is estimated with state and year-fixed effects.     

Tracking the Coverage of Public Policy in Mass Media

The average citizen often does not experience government policy directly, but learns about it from the mass media. The nature of media coverage of public policy is thus of real importance, for both public opinion and policy itself. It nevertheless is the case that scholars of public policy and political communication have invested rather little time in developing methods to track public policy coverage in media content. The lack of attention is all the more striking in an era in which media coverage is readily available in digital form. This paper offers a proposal for tracking coverage of the actual direction of policy change in mass media. It begins with some methodological considerations, and then draws on an expository case—defense spending in the United States—to assess the effectiveness of our automated content‐analytic methods. Results speak to the quantity and quality in media coverage of policy issues, and the potential role of mass media—to both inform and mislead—in modern representative democracy.     

An overview of women's health in the U.S. since the mid-1960 s

Women's health became intertwined with the second wave of feminism in the 1960s. The process and history of the interactions among physicians, feminists, health care consumers, activists, and politicians have brought women's health into the foreground of health research and curricular agendas in several ways. It identified major gaps in research and practice and initiated a critique of the current health care system at all levels; it originated from, and remains connected with, the non-medical community; it is interdisciplinary and requires interdisciplinary teams for research and clinical practice, as well as collaboration with colleagues in non-medical academic fields; it developed new curriculum focused on women's health; it emphasizes race, class, sexual orientation, and other diversities among women. The continuing presence of activists and feminist scholars will insure that health and science include women's needs to provide better health for all.