Effective Implementation In Practice: Integrating Public Policy and Management

Chapter OneFraming Implementation

By April 2014, Sandra Martinez, manager at Connect with Health Colorado, could finally stop to breathe and reflect on the events of the previous year.¹ The federal Affordable Care Act (ACA) was a major change in public policy (see Box 1.1), and her organization, a nonprofit formed by the legislature to implement the state's health care insurance marketplace, was at the center stage of Colorado's efforts to get the first wave of citizens enrolled. While in late 2013 public and national media attention reached fever pitch when operational challenges threatened the federal insurance website marketplace, Colorado was not caught in that controversy. Because it was one of the seventeen states that elected to operate ...