Hacker focuses largely on the political factors (interest groups, Congressional composition, key stakeholders, public opinion, polarization) and larger events (recession) influencing the discussion and eventual passage of the Affordable Care Act (ACA). Hacker's ACA topic is a useful one for analyzing policy success. Despite Hacker's detailing of how the act was watered down before passage, champions and supporters celebrated its passage and remarked on its eventual historical impact. Yet how many of us could give an accurate update on ACA implementation? I suspect no one (and if you can, please help the rest of us). I think this is because policy implementation is a largely unpublicized, often uninteresting process (at least to non-wonks). It typically involves public administrators who receive the law's language and are tasked with implementing the policy with varying degrees of autonomy. This makes the quality of implementation very difficult to predict and monitor, especially when you add so many arenas as is the case with the ACA (hospital administration, state agencies, private insurers, etc). As Patashnik notes, "...institutional shifts clearly affect reform sustainability...the institutional structures established to protect reforms may conflict with the mandates from pre-existing institutions, or they may lack the necessary incentives or capacities" (167)
Earlier in the semester, Arnold Meltsner noted that feasibility analysis should lead to policies that can be implemented. Yet it seems much of the discussion around feasibility is around the development (and ideally, eventual passage) of policy. What I often see missing from that discussion is consideration for exactly how a given program or policy will reach the individuals it's designed to affect. Implementation scholars point to analyzing how initial implementers (often bureaucrats) receive the policy - is there support among professionals in the given policy arena? Have concerns voiced by program recipients been truly considered in policy development? I would argue that the answers to these questions are quite relevant to analyzing policy "success", because they define whether or not a program or policy does what Hacker's list of political players worked hard to influence on the front end of policy making.
Though perhaps I'm overstating their importance. Can policy makers and "front-end" players as I've described them create policy in ways that ensure successful implementation? Do you think policy makers consider these questions?
I've chosen a complicated policy area in the ACA to make my point. Are there policy arenas where success is easier to identify or define?