Policy is hard to pass but often even harder to implement well. The challenge of implementation is created, in part, by the overly complex design and burdens that different layers of government face in turning those promises into reality. Schoolhouse Rock! painted a picture of policy making for everyday Americans showing that once the battle in Washington or the statehouse is over, the job is done (Warburton and Dorough 1976). Of course, we know that legislation and regulation do not equal implementation or experience of policy. A considerable amount of work goes into turning intangible ideas and intent into a tangible program or interaction with its end users. Often, the needs of the policy makers or implementing agency supersede those of the users—the populations affected by and/or interacting with a given policy or program. In her 2023 book Recoding America, Code for America founder Jennifer Pahlka delves into this disconnect through a masterful weaving together of vignettes from the recent past of state and federal policy implementation failures and successes. Code for America, launched in 2009, is a civic tech nonprofit that works with local, state, and federal government to improve the usability of their services and benefits for the public, creating new online portals like GetCalFresh.org and GetCTC.org to ease administrative burdens and increase engagement with programs such as the Supplemental Nutrition Assistance Program (SNAP) and the 2021 expansion of the child tax credit, both of which affect food security (Ettinger de Cuba et al. 2019 Shafer et al. 2022). Pahlka also served as deputy chief technology officer in the Obama administration and helped found the US Digital Service, which aims to improve delivery of government services and user experience.
The concept of administrative burden has grown in salience within policy and public administration research, reflecting the learning, compliance, and psychological costs we face when interacting with government programs and services (Herd and Moynihan 2019, 2020). These burdens ensure that government assistance often goes to those who need it less but have the ability and/or resources to navigate the burdens, which has the effect of locking those with even greater needs out of assistance (Christensen et al. 2020). Administrative burdens can be weaponized for ideological and/or racist ends (Michener 2018; Shafer and Ndugga 2020), shaping who engages with programs in ways that may sound like common sense to a broad population (e.g., work requirements) but do much more harm than good in practice (Chen and Sommers 2020; Haeder et al. 2021; Sommers et al. 2020; Underhill et al. 2023). Policy scholars tend to focus on administrative burdens from the perspective of effectiveness and policy feedback, whereas Pahlka shares numerous stories from inside the policy implementation process from when she and others were brought in as technologists to help implement, or rescue the failed implementation of, a new initiative or policy change. These are related parts of the process that translate policy intent into downstream outcomes, either intentionally (e.g., work requirements) or unwittingly (e.g., poorly designed websites or forms), with her perspective as a technologist providing context for the mechanisms of action that lead to the observed effectiveness and policy feedback.
The book's early chapters focus on a key technological and policy challenge: the onset of the COVID-19 pandemic and the need to support tens of millions of Americans through the resulting unemployment crisis. Chapters 1 through 3 center on the California Employment Development Department during the pandemic, exploring how they struggled to even quantify the backlog in unemployment applications due to layers of “modernized” information systems and how throwing more people at the problem actually made things worse because of the training burden created for the experienced employees, who were the only ones who had the expertise to effectively navigate their systems. Chapter 4 delves into how government procurement failed to achieve the desired outcomes for the Department of Veterans Affairs (VA) with “solutions” that only work in the particular way that was specified to the vendor. For example, the Veterans Benefit Management System application only allowed the form to be filled and submitted electronically if someone had a particular combination of versions of Internet Explorer and Adobe Acrobat Reader, which worked for people working at the VA but for hardly any of their users—veterans and their families—outside the organization. Once the form was fixed and simplified, application volume for VA benefits exploded so much that some suggested going back to the old form to reduce processing burdens. To some, being able to keep up with application volume mattered more than helping more veterans.
Chapter 5 describes how the federal government went from being a leader in computing to outsourcing the majority of it and lagging behind, with chapter 13 later discussing how technologists in government are now fighting back against this trend. Rather than letting experts and technologists work with contractors collaboratively, the rigidity of these relationships lead to statements like “I don't say a word until there's a COTR [contracting officer's technical representative] in the room,” (109), resulting in more focus on contract details than on the end goal and how it affects the American people trying to interact with a program. It is difficult to foresee all of the ways in which a large project might need to change as the infrastructure and rules are being built, making it nearly impossible to perfectly sketch out a budget and functionality years ahead of time. Pahlka argues that technology needs to be owned, not outsourced, when it is core to the agency's mission and service, providing the ability for a more adaptable approach rather than a cycle of a rigid set of contract specifications that does not lend itself to evolution.
This tension about the “proper” role of government in owning and executing its own technological imperatives leads into chapter 6, exploring the launch of the Affordable Care Act health insurance Marketplace (accessible online at healthcare.gov) in 2013, which featured ignominious statements such as “[t]he website is not what we do” (118). However, this “was the first time the highest priority of the White House was the performance of a website” (126) that was tied to the most sweeping health insurance reforms in half a century. Chapter 7 discusses the 212-item application for SNAP benefits in California in the context of user research on forms and processes so byzantine that no one has the power to help the user. Chapter 9 adds more on SNAP as well as the earned income tax credit and benefits screeners. Chapter 8 delves into the “procedure fetish,” where legalistic thinking has taken over and made our government services technocratic, risk averse, and unhelpful. For example, state and federal officials failed to allow the use of nasal swabs from an already-running clinical study in Seattle in early 2020 to help detect COVID spread into the United States, leading to delays in response and increased deaths.
Chapters 10 and 11 explore how our attempt to make things uniform and equitable means we cannot prioritize and thus lose the plot in the process (e.g., not changing an online form because community organizations may have paper copies that would not be updated as quickly). We should be focusing on fulfillment of the mission and end user outcomes, not blind obedience to the internal hierarchy and broken processes. Chapter 12 illustrates an example of well-meaning policy—expunging marijuana convictions—that runs into how difficult it can be to automate policy when lots of documents, decisions, and stakeholders are involved. It raises the consideration of designing policy better, but also designing our agencies and data systems more thoughtfully, in light of the fact that we may want to change approaches in the future. This goes beyond administrative burdens in a way, recognizing that building flexibility into how we collect and organize data affects our ability to follow through on policy promises that we may not have foreseen decades ago, such as expunging marijuana convictions. The book concludes by arguing that technology is key to delivering on our policy promises for the American people. Instead of the bureaucracy being the stakeholder, we need to “recode” our thinking and focus on the users—all of us. Funding and planning for federal and state technology need to be fundamentally different, working from the more attainable common ground of improving delivery and following through on policy intent rather than agreeing on the structure of benefits or eligibility for a given program.
This book and the policy vignettes within it do an excellent job of illustrating the competing aims of policy design within and adjacent to government based on one's positionality. Pahlka notes that “[a]t times it almost seems that status in government is dependent on how distant one can be from the implementation of policy” (15), arguing that we need to fundamentally rethink our policy and programmatic design processes to put the needs of the end users ahead of the needs of the bureaucracy. We have seen policy feedback with the implementation of the Affordable Care Act and Medicaid expansion (Campbell 2011; Grogan and Park 2017; Jones, Bradley, and Oberlander 2014; Moynihan and Soss 2014; Trachtman 2020), but that example is largely focused on big-picture policy decisions (e.g., whether to expand Medicaid, whether to develop a state-based Marketplace or rely on healthcare.gov) rather than on the nuances of program administration and user-centered design of forms and processes. Only in recent years have we seen a more concerted focus on public interest technology or civic technology, spurred in part by groups like Code for America outside of government and the establishment of the US Digital Service, which Pahlka advocated for and then led. However, she does not view technology as a panacea. She argues that investments in modernization of information technology infrastructure make for a good sound bite but often fail to solve the root cause of the problem and just create additional layers of complexity in program management and delivery. The book's vignettes, its systems thinking about policy design and implementation, and the different lens it uses provide a good opportunity for using this book or selected chapters of it in the classroom across a range of disciplines—such as health and public policy, political science, public administration, economics, and sociology—that are engaged with health and broader public policy issues.
Recoding America is a compelling read for anyone interested in how policy making and real-world challenges are translated through the often broken processes of government agencies and prioritization of bureaucratic needs over the needs of those who are being served. Pahlka artfully illustrates the importance of policy design and systems through numerous examples of high-profile policy rollouts and crises from her perspective as a technologist, which complements a growing emphasis on administrative burdens at the federal level (EOP 2021). Easing administrative burdens requires policy makers and agencies to create policies and programs that are easier to understand and implement while also improving the digital avenues through which the public interacts with them, which is where Pahlka and other technologists can help. These are important issues to consider in an era where the role of government and bureaucracy differs depending on your partisanship. We temporarily removed administrative burdens and expanded the social safety net during the COVID-19 pandemic, shifting burdens back to the state or removing them altogether, and we managed to hold poverty, food insecurity, and other material hardships at bay during a massive crisis. But as shown in Recoding America, this only works well and is sustainable when systems are designed to pivot quickly rather than being reliant on very manual processes or decades of experience in navigating them. When systems and staff headcounts cannot flex to meet the need efficiently, as shown in the California unemployment vignette, it raises the question of whether we are well equipped to shift burdens back to the state without first redesigning the policies and/or systems that will be stressed by them. The end of the COVID-19 public health emergency has seen more than two thirds of Americans disenrolled from Medicaid (69%) lose coverage for procedural reasons, not ineligibility (KFF 2024). Although states are required to attempt ex parte or automated renewals, there is considerable variability, ranging from 99% of renewals in North Carolina occurring this way down to only 8% in Pennsylvania, with the rest requiring paperwork to maintain coverage.
Recoding America suggests we can do better by integrating technologists into the ideation, design, and implementation of policy and programs, allowing us to achieve our policy objectives more efficiently and rebuild Americans’ trust in government.
