Administrative Burdens in Health Policy

• Published in: Journal of health and human services administration Vol. 43; no. 1; pp. 3 - 16
• Main Authors: Herd, Pamela, Moynihan, Donald
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SPAEF 22.06.2020; SAGE Publications; Southern Public Administration Education Foundation, Inc; Southern Public Administration Education Foundation
• Subjects: Abortion; Beneficiaries; Compliance; Enrollments; Health care; Health care expenditures; Health care industry; Health care policy; Health care services accessibility; Health insurance; Health policy; Health services; Health services administration; Management; Medicaid; Medicare; Patient Protection & Affordable Care Act 2010-US; Political aspects; Political power; Politics; Public policy; State government; Uninsured people; United States; United States > US; Administrative burdens; Medicare; Medicaid; Affordable Care Act
• ISSN: 1079-3739; 2168-5509
• DOI: 10.37808/jhhsa.43.1.2

The US healthcare system is enormously complex, begetting a seemingly endless array of bureaucratic obstacles that make it both costly and difficult to navigate for users. We apply the administrative burden framework to three particular aspects of health policy: the Affordable Care Act (ACA), Medicaid, and Medicare. The applications are more illustrative than definitive, intended to demonstrate that administrative burdens play a key and underappreciated role in how policies are implemented, sometimes deliberately so. The following claims arise from our framework. First, burdens are consequential – they make a difference in our lives, most obviously in terms of access to healthcare. Second, administrative burdens are distributive: some groups, like the poor, are more burdened than others. Third, burdens are a function of political and administrative choices, constructed via processes of both policy design and implementation.