Runaway Bureaucracies or Congressional Control?: Water Pollution Policies in the American States.

Over the last several decades, there has been persistent scholarly controversy concerning Congress's influence on administrative decision-making. Scholars in the 1970's argued that the bureaucracy was out of control and not subject to ongoing Congressional influence, while in more recent years scholars using principal-agent theories have argued that Congressional control over administrative decision-making is common. This work suggests that both of these arguments have neglected the importance of ongoing statutory influence on policymaking at the federal and state levels, and - in so doing - have failed to emphasize an important source of Congressional influence on US domestic policy. This work assesses ongoing statutory influence on administrative decision-making in US water pollution control policy. It assesses federal and state compliance with Congress's statutory instructions, and focuses on policymaking at the state level where the rubber actually meets the road in water pollution control and many other areas of American domestic policy.Drawing evidence from historical and cross-sectional analyses of the water pollution policymaking process, the argument here is that Congress guides administrative policymaking, ex ante, through the statutory directions it provides for policy implementation - even in policy areas like water pollution control that rely heavily on intergovernmental administration. However, this guiding function is imperfect, as substantive policy outputs may stray from Congress's statutory directions as a result of factors that come into play during the implementation process. These factors include the nature and variability of directions provided by political leaders at the federal level, state level policy influences, and variable levels of federal oversight. The analyses here also point out that the relative strength of these influences at the state level varies depending on the policy output being considered, and these outputs are affected in fundamental ways by statutory design. Congress, it is suggested here, has substantial long-term influence on bureaucratic policy outputs, and statutory design is a fundamental mechanism through which this influence is realized. This conclusion, in turn, suggests a need for increased attention to Congressional policy design in water pollution control and other policy areas

Healthcare Reform Repeal Efforts in the United States in 2017: An Inquiry into Public Advocacy Efforts by Key Interest Groups

The Affordable Care Act (ACA) was subjected to repeated repeal and replace efforts in the United States Congress in 2017. Attempts to repeal and replace the law failed, but penalties for not complying with its mandate that individuals purchase health insurance were removed in tax legislation passed late in the year and administrative actions taken by President Trump yielded additional concerns about the stability of the law’s reform approach and the expanded health insurance access that it created. This article explores public advocacy efforts by key interest groups from three major policy sectors—health providers, the insurance industry, and the business community—that had served as an “axis of opposition” to past American healthcare reform efforts. It identifies resource and incentive policy feedback effects that appear likely to influence these groups due to design features of the ACA and assesses whether patterns of advocacy efforts in 2017 are consistent with what might be expected if these design features had their predicted effects. Our assessment reveals patterns of interest group advocacy that are consistent with what might be expected to arise from resource and incentive based policy feedback effects, and interest group political dynamics that differ from what was in place prior to passage of the ACA. It also reveals advocacy patterns that are not well explained by resource and incentive based policy feedback effects, and—in so doing—yields insights that are relevant to the design of policy reforms and future research

Using the Pathways Community HUB Care Coordination Model to Address Chronic Illnesses: A Case Study

Background/Objectives: Ohio communities are developing and expanding care coordination initiatives to integrate care for low-income pregnant women. Some of these initiatives are guided by the Pathways Community HUB model, which uses community healthworkers to address health, social, and behavioral risks for at-risk populations. This study documents the development, challenges andmanagement responses, and lessons learned from implementing a Pathways Community HUB care coordination program for anotherpopulation -- low-income adults with chronic disease risks.Methods: The study utilizes data extracted from the Care Coordination Systems (CCS) database used in Lucas County, Ohio between2015 and 2017 and interviews with program managers. Based on CCS data and insights from those interviewed, we describe the development and accomplishments of a Pathways Community HUB program for adults with chronic illnesses and identify challenges and lessons learned.Results: The Toledo/Lucas County program addressed more than half of 3,515 identified health and behavioral risks for 651 low-income adults in the program during its first two years of operation. Key challenges included building community support, establishing capacities to coordinate care, and sustaining the program over time. Establishing community networks to support program services and developing multiple funding sources are key lessons for long-term program sustainability.Conclusions: Documenting challenges and successes of existing programs and extracting lessons to guide implementation of similarpublic health efforts can potentially improve delivery of interventions. The Pathways Community HUB model has demonstrated success in addressing risks among at-risk adults. However, more comprehensive assessments of the model across different populations are warranted

“Information and Environmental Policy: A Tale of Two Agencies”

In recent years, scholars and practitioners have focused increasing attention on the role of information in achieving environmental policy goals. This paper develops a framework for understanding how information is used in making environmental policy, and compares the kinds of information development and communication efforts undertaken by the U.S. Environmental Protection Agency (EPA) and the European Environment Agency (EEA). The analysis suggests that institutional factors such as organizational structure and the mix of policy instruments used by the agency affect the kinds of information efforts undertaken. It also suggests possible areas of focus for environmental information efforts within the EPA and the EEA. These suggestions and the framework provided may also be of use to other environmental agencies

"Balancing interests in the EU and the U.S.: A comparison of environmental policymaking institutions and water policy outputs"

In multi-level political systems such as the European Union and the United States, governing institutions balance the influence of territorially and functionally based interests in the policymaking process. This paper argues that-in comparative terms-EU intuitional structures for environmental decision-making provide relatively strong opportunities for influence by territorially based interests, while environmental policymaking institutions in the U.S. tend to allow for the exercise of relatively greater levels of influence by functionally based interests. It further argues that these institutional differences have implications for water policy outputs in the two political jurisdictions. Specifically, it suggests that the EU's more geographically oriented institutional structures enable a relatively high level of horizontal integration across policy sectors during the formulation stage of the policy process. In the U.S., by contrast, relatively high levels of institutional receptiveness to functionally oriented interests have contributed to more vertically integrated structures for drinking water and surface water policy implementation