This research is a project of the Risk and Social Policy Working Group, (https://www.riskandsocialpolicy.org/) , supported by the U.S. National Science Foundation, from the Directorate for Social, Behavior and Economic Science, the Division of Social and Economic Sciences, and the Decision, Risk and Management Sciences Program (Awards 2030316 and 2102905).
1The COVID-19 pandemic dominated public and policymaking agendas of governments worldwide for nearly two years, revealing suboptimal policy responses in multiple policy domains including public health, economics, education, manufacturing, and many others. This heightened issue attention led to significant emergency policy action by elected officials and public health agencies across U.S. states and globally, as policymakers scrambled to impose risk mitigation measures aimed at reducing the spread of the virus. Notably, the U.S. federal government’s failure to enact nationwide risk mitigation policies or other response measures and devolve responsibility to the states meant that they were left to craft crisis mitigation policies (Birkland et al., 2021), resulting in a wide variety of policies across the U.S, (Crow et al., 2023).
2While the flurry of executive actions and risk mitigation policies adopted during this period have been well-documented and carefully analyzed by the policy process community (Crow et al., 2022; DeLeo, Taylor, Crow, & Birkland, 2021; Eichenberger, Varone, Sciarini, Stähli, & Proulx, 2023; Möck, Vogeler, Bandelow, & Hornung, 2023), state-level executive actions taken during crisis in the U.S. (based on the limited emergency powers of U.S. governors to carry out immediate crisis response) typically carry with them restrictions that limit the lifespan (and sometimes the degree of change possible) of such policies. Few studies have considered the lasting implications of COVID-19 policymaking in the U.S., or the extent to which policies resulted in substantive and lasting changes that transcend the COVID-19 pandemic specifically. Unlike temporary emergency changes issued through the executive powers of U.S. governors, lasting changes made in U.S. states are often the byproduct of a tedious and lengthy legislative process. The exploratory and descriptive analysis presented here constitutes a critical first step toward unpacking the extent to which state-level legislation enacted during the COVID-19 pandemic made substantive changes to subnational public health institutions in the U.S., thereby enabling them to better respond to future public health outbreaks. Specifically, we ask to what extent COVID-19 U.S. subnational policy changes point to important directions for future pandemic-related research, such as whether the heightened agenda status of COVID-19 led to lasting policy change through legislation and what types of policy changes were made.
3This article explores these questions through a descriptive analysis of state-level policy activity, along with an initial exploration of future research directions. In doing so, the primary function of this article is to not only begin to map the dizzying array of state legislative actions (or a lack thereof) that took place during the first years of the pandemic, but also to begin to carve out future research directions. Such pathways can provide scholars working at the intersection of agenda setting, policy change, and subnational institutions with important areas they can explore. We find that state-level legislatures were active during the COVID-19 pandemic as we would expect, given the salience of the crisis. However, as is usually the case when new problems arise, the volume of legislation introduced was far greater than that which passed; a majority of passed legislation was very narrow-bore enactments that enabled policy actions designed to channel temporary federal COVID-19 assistance funds to state agencies and projects rather than making institutional or structural changes to improve public health response. This descriptive analysis suggests that legislation enacted during this period did not result in the type of lasting policy change that one would expect will make U.S. states better prepared to handle future public health crises. These findings open a window into what will be important research questions for policy scholars moving forward.
4We begin by briefly examining the literature on agenda and policy change, with a focus specifically on the dynamics of change in the aftermath of crises. We then explore the distinct but closely related literature on policy learning, which suggests that crises can provide important opportunities for making normatively desirable improvements to existing policy regimes. We present our methodology before descriptively analyzing some general trends in agenda and policy change in the U.S. state legislatures. We conclude by considering the implications of these results for the larger community of policy scholars interested in crises, learning, and change, highlighting future research directions on the drivers of post-pandemic policy change and learning.
5Crises and disasters are important for shaping the policy agenda. They can serve as potential focusing events, which are events that are sudden, rare, reveal a harm or potential for harm, and are known to policy makers and the public virtually simultaneously (Birkland, 1997; 1998). We stress the potential of focusing events to open a window of opportunity and shape the policy agenda by shifting attention to a policy problem revealed by the crisis. Focusing events draw attention to a policy problem that was previously underappreciated, unknown, or misunderstood (Birkland, 1997; Kingdon, 2003) and cause shifts in the policy image (Baumgartner & Jones, 2009; Stone, 2011). Changes in issue attention and shifts in policy image allow policy problems to be defined and redefined (Elder & Cobb, 1983; Rochefort & Cobb, 1993), gain salience, and advance on the agenda relative to other competing issues.
6While sudden onset disasters, like earthquakes, hurricanes, or plane crashes, are typically labeled as potential focusing events, public health crises often reveal themselves more gradually and across time through the accumulation of problem indicators (DeLeo, 2018). Indicators refer to measures of a policy problem (Kingdon, 2003). In the case of public health crises, these indicators may refer to the number of disease cases and deaths as well as hospitalization rates (DeLeo, 2018). Just as focusing events can help change perceptions of a particular policy problem, so too do problem indicators change the way in which an issue is understood (DeLeo & Duarte, 2022; Innes, 1990; Jones & Baumgartner, 2005; Stone, 2011). However, unlike focusing events, a term that tends to describe a disaster that has already occurred, problem indicators can, in some cases, point to an emerging hazard that, if ignored, will likely worsen over time (DeLeo, 2018).
7Interestingly, the COVID-19 pandemic demonstrated characteristics of both focusing events and indicator-driven agenda change. To be sure, COVID-19 failed to meet most of Birkland’s (1997) criteria for a potential focusing event. It was neither sudden nor confined to a specific geographic area. It was, by definition, a world-wide phenomenon that revealed itself over a period of weeks if not months as cases began to stack up globally. Experts observed the emergence of the virus and were concerned in early 2020 that a pandemic may be imminent well before the issue was tackled by political institutions. However, the policy effects of the pandemic were, in many respects, analogous to a focusing event in that COVID-19 effectively leapfrogged most other items on the institutional agenda when it triggered a significant increase in policymaker and media (and, by extension, public) attention (DeLeo et al., 2021). That uptick seemed even more sudden and unsettling to the public and to policy makers when public health officials—backed in most cases by elected and appointed officials—called for the closure of schools, workplaces, and other places where people congregate. Such a sharp disruption to the rhythms of ordinary life could not be ignored as a significant shock to the social structure.
8Agenda change is a dynamic and fluid process of marrying problems, solutions, and politics (Kingdon, 2003) where agenda dynamics are driven by information processing and issue attention (Baumgartner & Jones, 2009). However, we are particularly interested in the rarer occurrence: policy change. Previous research suggests that the pandemic induced important policy changes at the federal level (DeLeo et al., 2021). At the same time, the COVID-19 pandemic resulted in a flurry of executive actions at the subnational level as state governors struggled to mitigate the virus’s spread through non-pharmaceutical interventions (Crow et al., 2022).
9Previous research has explored the dynamics of policy change after similarly large-scale crises. The most notable example is the bevy of studies exploring policymaking in the wake of the September 11, 2001, terrorist attacks in the U.S. For example, Birkland (2004) shows that while 9/11 opened a window of opportunity for policy change, many of the policies enacted were either not innovative or were pre-existing ideas that were simply repackaged in the aftermath of the event, reinforcing Kingdon’s (2003) finding that policy ideas are not often novel. May, Jochim, and Sapotichne (2011) similarly characterize the post-9/11 policy regime as being “anemic”, adding that the sprawling counter-terrorism apparatus created in the wake of the crisis fell short of accomplishing its overarching goal of creating greater institutional cohesion around a shared concept of homeland security. In short, these studies suggest that, even after a disaster, substantive policy change is difficult and unlikely, or may fall short of the goals the proponents of change hoped to achieve during the sudden burst of attention after a disaster. In simpler terms, while big events should, intuitively, create big change, this is not often the outcome. These findings are consistent with the literature on learning after natural disasters (Crow & Albright, 2021; O'Donovan, 2017; Taylor, Jeschke, & Zarb, 2023).
10However, the type of comprehensive analysis that is present in other studies of crisis and learning, including the longer-term implications of policy change and improvements to preparedness for future crises, is missing from the current scholarship on the COVID-19 pandemic. We find this omission concerning given the scale and scope of the pandemic. Indeed, studies that have considered COVID-19 policy change have largely focused on national government institutions, like the U.S. Congress (DeLeo et al., 2021), while ignoring state legislatures and other subnational governments. This gap in the research is problematic because, in the U.S., response to public health emergencies is a state function, and state legislatures are constitutionally responsible for funding and implementing many of the executive initiatives launched during the pandemic, thereby playing a critical role in determining the trajectory and efficacy of state risk mitigation programs. Moreover, although U.S. state governors and public health departments retain considerable authority to enforce risk mitigation policies during crises, the creation of more durable policy changes or policy innovations is ultimately the responsibility of state legislatures. State legislatures will likely determine the extent to which subnational governments enact long-term, fundamental policy changes to better position subnational public health institutions to respond more effectively to future disease outbreaks. Conversely, state legislatures may fail to enact such changes, suggesting that little has been learned from the pandemic and that those states are at least as vulnerable, if not more vulnerable, to future pandemics, as state public health systems struggle to address the pandemic and to gain public support for the measures needed to be prepared for the next pandemic.
11Agenda-setting is crucial in bringing attention to important issues, but it does not always lead to policy change. The process of learning is a fundamental mechanism for bringing about policy change. Policy learning can take different forms, ranging from shallow to deep. Learning specific lessons about the utility of policy tools or processes is important, but these are relatively ‘thin’ or shallow types of learning as identified in the disaster literature (Albright & Crow, 2021; Crow & Albright, 2021). Gaining an understanding of the root causes of problems, such as uncertainty and the gradual escalation of risks over time, as well as determining the suitable responses by organizations, can be more closely related to deep learning. This type of learning demands a more extensive and deliberate examination of the lessons learned and the role that organizations can play in either exacerbating, mitigating, or resolving risk-related challenges.
12May (1992) identified three types of policy learning. First, instrumental learning refers to a new understanding about how a policy tool works, is designed, or is implemented. This type of learning often occurs through trial and error and may not be a deliberate or intentional process. Measures of instrumental learning include changes in specific policy tools or internal government processes (O'Donovan, 2017). Second, social policy learning focuses on developing a new understanding of a policy by changing the social construction of the problem and the causal reasoning underlying the definition of the problem (O'Donovan, 2017). This type of learning often involves a change in long-term policies or community plans, which may be reflected in new goals or a shift in the defined scope of the problem (Crow & Albright, 2021). Third, political learning involves acquiring knowledge about the effectiveness of strategies that policy advocates use to promote policy ideas or draw attention to problems (Fifer & Orr, 2013). This type of learning may be reflected in the adoption of new approaches to public involvement or intergovernmental strategies (Albright, 2011). Table 1 summarizes different types of learning definitions and measurements.
Table 1. Crisis-Induced Learning Concepts and Measures
Learning Type
|
Definition
|
Measurements of learning
|
Instrumental learning
|
New understanding about how a policy tool works, is designed, or implemented. Learning occurs by trial and error and is not necessarily purposive
|
-
Change in specific policy tools
-
Change in internal government processes
|
Social policy learning
|
New understanding of a policy by a change in the social construction of the problem and the causal reasoning underlying the definition of the problem
|
-
Statement of new goals
-
Change in long-term policies or community plans
-
Change in defined scope of problem
|
Political learning
|
Changes in knowledge about the effectiveness of strategies that policy advocates use to advance policy ideas or draw attention to problems
|
-
Adoption of new approaches to public involvement
-
Adoption of intergovernmental strategies
|
Source: Adapted from May (1992).
13Previous research suggests that policy activities undertaken by U.S. state governors and other executive agencies during the pandemic tended to be fairly superficial in that states were attempting to respond, often in near real-time, to rapidly evolving pandemic conditions. Learning tended to break along partisan lines with Democratic states adopting more substantive measures earlier in the pandemic relative to Republican states. Crow et al. (2022) characterize this learning as preemptive learning, meaning that states frequently sought to derive lessons in anticipation of changing hazard conditions as opposed to the type of protracted and measured response observed in the aftermath of disaster. In addition to being temporary, executive actions taken by governors did not address bureaucratic, organizational, or political failures highlighted by COVID-19, nor did they take a holistic view to address previously unknown gaps in public health institutions.
14However, we expect that the context in which learning took place evolved and changed over the course of the pandemic. In the face of the outbreak of COVID-19 in early 2020, state governors responded by activating emergency powers, thereby providing them a fair amount of latitude to unilaterally impose various non-pharmaceutical interventions (e.g., mask wearing, stay-at-home orders, business and school closures) and, later, vaccine mandates. In effect, this meant state executive branches became the dominant venue for guiding subnational COVID-19 policy, although state legislators still retained considerable authority over budgetary decisions.
15Almost all US state-level emergency declarations expired by the spring of 20231, which means the COVID-19 pandemic thereafter entered a new phase in its evolution. Whereas the period between 2020 and early 2022 was marked by an ever-present need to make rapid risk mitigation decisions in the face of changing disease conditions, the most recent and ongoing period offers, at least in theory, a moment of greater retrospection and the opportunity to derive more substantive lessons, particularly at the legislative level. More specifically, there exists an opportunity for state legislatures to derive lessons aimed at bolstering the capacity of subnational public health institutions in order to allow them to better navigate the next public health emergency. This initial descriptive analysis of state-level COVID-19 pandemic legislation establishes an understanding of the role legislatures played in the first years of the pandemic so that we can characterize these early actions in comparison to those that may come later. This analysis also provides a lens through which a longer-term pandemic-related research agenda can be articulated. Because legislation can take multiple sessions to enact and because the legislative process is tedious, we begin the exploration of these questions using a descriptive approach.
16As we learned when analyzing thousands of state-level executive orders issued between 2020 and 2022, one of the most important steps before undertaking extensive coding and analysis of individual policies is to first understand if there are major patterns that lead to meaningful research questions. While we anticipate that legislation might be the venue within which we observe substantive policy learning and change, it is also possible that we may not see major changes even in the aftermath of a profound sector-spanning crisis like COVID-19. It is also important to note that, while long term enduring policy change is necessary to change the policy domain and institutions within which public health response occurs, it does not guarantee more successful outcomes. Policy change does not always lead to normatively better policies and outcomes. As part of this broad research agenda related to COVID-19 policy change, understanding the effectiveness and direction of such change is vital. This article, however, focuses on the first steps of understanding the bigger puzzle of agenda setting, policy change, and learning after COVID-19.
17The literature summarized above suggests that crises like COVID-19 could heighten the salience of public health and pandemic-related issues as it did with U.S. governors’ executive actions (Crow et al., 2023). In legislative venues, however, there is greater potential for lasting and substantive policy change to the public health system rather than temporary risk-mitigation measures possible through emergency executive powers, potentially allowing states to better respond to future public health outbreaks. Simultaneously, we also know that COVID-19 policymaking experienced high levels of partisan polarization (Hart, Chinn, & Soroka, 2020; Hegland et al., 2022; Kerr, Panagopoulos, van der Linden, 2021) and that policy learning and change is rare even in repeated disaster events (O'Donovan, 2017; Crow & Albright, 2021; Birkland, 2006). Understanding major patterns in legislation is an important first step in developing research agendas towards understanding policy change in the wake of such a significant crisis as COVID-19, which is why we chose to interrogate basic assumptions about policy change after (or during) a crisis and conduct a descriptive analysis here. As such, we posit the following research questions:
RQ1: Was the high issue salience of the COVID-19 pandemic observed in executive actions, media, and public discourse reflected in the salience of public health issues in state legislatures? (Agenda attention)
RQ2: Did heightened public health agenda attention in state legislatures lead to policy changes in U.S. states? (Policy change)
RQ3: Were policy changes in U.S. states substantive in nature, focused on institutional changes to better respond to future public health crises? (Policy learning)
18We address these questions through a descriptive analysis of the patterns of bill introduction and enactment between 2020 and 2022 in the 50 U.S. states. The data and analysis approach used are described next, followed by a discussion of the findings and an articulation of a longer-term research agenda.
19We build on previous research (Crow et al., 2023) that focused on emergency orders by examining U.S. state legislative policymaking during the same period of time. Data were collected from the National Conference of State Legislatures (NCSL) through a search for all legislation related to COVID-19. Table 1 in the Appendix includes counts of enacted or adopted legislation across all policy topics (e.g, public health, education, etc.) using the keyword search: COVID. This count data is used to understand the frequency of legislative introduction, the focus of such legislation, and the legislative outcomes of all legislation introduced across the 50 U.S. states between 2020 and 2022.
20It is important to note that it is common for a legislative body in the U.S. to use the ‘shell’ (number, title) of an old bill and ‘amend’ the bill to allow a policy to pass quickly rather than moving through committees and full debate. This was done at the U.S. federal level in 2020 to pass several rounds of major stimulus legislation and was also done in some states, which is why a few bills indicate they were introduced in 2019. The findings presented here are exploratory in nature, and we therefore utilize descriptive analyses for the reasons described above, primarily that we first need to know if (1) there was any policy change across U.S. states and (2) whether that change was substantive enough to warrant more in-depth analyses of causal relationships between changes and the state-level dynamics present in institutions, politics, and COVID-19 problem indicators.
21We present our findings by research question, beginning with our agenda-setting question, which asked whether there was an increase in attention to public health issues in state legislative bills that coincided with the public attention to COVID-19 between 2020 and 2022.
RQ1: Was the high issue salience of the COVID-19 pandemic observed in executive actions, media, and public discourse reflected in the salience of public health issues in state legislatures?
22Legislative issue salience is measured here by legislative attention to an issue. Policy scientists frequently differentiate between the systemic agenda, which describes the various issues occupying public attention, and the institutional agenda, which describes the much smaller slate of issues occupying policymaker attention (Cobb & Elder, 1971). That COVID-19 triggered a sharp increase in public attention to public health issues (the systematic agenda) is well-established (Ng & Tan, 2022). In this analysis, by contrast, we seek to assess change in the institutional agenda. We operationalize legislative issue attention as the introduction of a bill related to COVID-19. Figure 1 illustrates the count of all legislative introductions related to COVID-19 over time by policy topics. Health-related legislation was the most prominent (1,191 bills), followed by fiscal legislation (597 bills, many of which focused on allocating the federal stimulus dollars from the massive COVID-19 bills passed by the U.S. Congress), housing and welfare support (human services, 164 bills), and other. “Other” includes topics that were less frequent or substantive, including transportation (mostly public transit), education, criminal justice, elections, employment, legislative resolutions honoring front line workers, and legislative changes to the operation of legislatures. In instances when multiple topics were addressed in a single bill, we included the bill in the category that appears first in a bill.
Figure 1. Introduced COVID-19 Legislation in 50 U.S. States 2020-2022
Source: the Authors
23Based on Figure 1, legislative issue salience of COVID-19 and pandemic/public health issues was apparent in legislatures as measured by legislative activity across U.S. states. Indeed, policy attention appears to fluctuate with peaks and valleys of recorded COVID-19 cases and deaths (Johns Hopkins Coronavirus Research Center, 2024). What remains unclear, however, is whether this heightened legislative attention translated into policy change. Because prior literature roundly supports the finding that partisan politics predict the policy environment during COVID-19 (Gadarian, Goodman, & Pepinsky, 2021; Gusmano et al., 2020), it is possible that legislative introductions may not lead to successful legislative outcomes if the bills introduced are ‘statement’ bills that are not substantive but are purely political in nature (e.g., prohibiting local governments from enacting mask mandates, prohibiting schools from closing, etc.). Of course, the outcome of such bills would also depend on the make-up of the state legislatures, with highly partisan legislatures likely to be more amenable to such ‘statement’ bills.
24We next examine whether legislative agenda attention demonstrated by the introduction of legislation in state legislatures also led to policy changes through the passage and enactment of legislation.
RQ2: Did heightened public health agenda attention in state legislatures lead to policy changes in U.S. states?
25Figure 2 shows the topics and timeline of enacted bills. In looking at Figures 1 and 2, both attention and policy change were focused on health and fiscal activity compared with the other potential subtopics that COVID-19 encompasses.
Figure 2. Enacted COVID-19 Legislation in 50 U.S. States 2020-2022
Source: the Authors
26And yet, while our data revealed that issue salience was high for COVID-19 related legislation (Figure 1), it did not translate into policy change at proportionately similar high levels. For example, of the 373 Public Health bills that were introduced during 2020-2022, only 68 were enacted or adopted (Table 2, Appendix).
27Given the larger proportion of health-related bill introduction and enactment in comparison to other legislative activity, we take a more detailed examination of the data to compare the bills that were introduced and those that passed in each state (Figure 3). There is a notable gap between the introduction of bills focused on public health and the enactment of bills, suggesting that many of the bills may have been partisan in nature (i.e., political statement bills). Indeed, further examination reveals that no state with a divided legislature enacted a public health bill (Figure 4), which suggests that political partisanship played a role in where bills were enacted.
Figure 3. Introduced and Enacted Public Health Legislation by U.S. States 2020-2022
Source: the Authors
Figure 4. Enacted Public Health Legislation by Control of State Government 2020-2022
Source: the Authors
28To further assess the role of partisanship, we examine the same public health bills by partisan affiliation of the bill sponsors (Table 2). Bipartisan bills were far less common across states, with bill introduction being overwhelmingly partisan — from both Democrats and Republicans. The bipartisan bills, however, had a greater chance of getting passed proportionally.
29Table 2. Partisan analysis of Public Health Bills
Author(s)
|
Democrat only (%)
|
Republican only (%)
|
Bipartisan (%)
|
NA/Other (%)
|
Total
|
All introduced legislation
|
162
(43.4)
|
145
(38.9)
|
50
(13.4)
|
16
(4.3)
|
373
(100)
|
Enacted/adopted legislation
|
20
(29.4)
|
20
(29.4)
|
23
(33.8)
|
5
(7.3)
|
68
(100)
|
States that enacted/ adopted legislation
|
CA (6), CT (2), HI (2), LA (1), MA, NY (4), OR, VA, VT, WA
|
GA, IN, KY, MI (3), MT, NH, NV, PA, SC, TN, UT (4), VA (3), WI
|
CA (4), DE, IL (2), LA, MS (3), MD (2), NC (2), NJ (3), OH, OR, PA, TX, VA
|
|
|
Source: the Authors
30To further understand COVID-19 legislative activity, we examine the data by three potential influential variables that encompass both problem indicators and political partisanship: (1) hospitalization rates (Figure 5); (2) COVID-19 case counts (Figure 6); and (3) presidential vote in the 2020 election (Figure 7). The only variable that shows a clear relationship between legislative volume and these variables is presidential vote share in the most active states, with Biden votes correlating with higher levels of legislative activity. This suggests that partisan commitments may be more important drivers of agenda activity than are problem indicators of the COVID-19 crisis.
Figure 5. Public Health Legislative Activity by Percent Inpatient Hospitalization in January 2021
Categorization of states according to legislative bill introduction Low: 0-2; Moderate Low: 3-5; Moderate: 6-9; Moderate High: 10-14; High: 15+
Source: the Authors
Figure 6. Public Health Legislative Activity by COVID-19 Case Counts in January 2021
Categorization of states according to legislative bill introduction Low: 0-2; Moderate Low: 3-5; Moderate: 6-9; Moderate High: 10-14; High: 15+
Source: the Authors
Figure 7. Public Health Legislative Activity by Biden Vote Share in 2020 Election
Categorization of states according to legislative bill introduction Low: 0-2; Moderate Low: 3-5; Moderate: 6-9; Moderate High: 10-14; High: 15+
Source: the Authors
31Above, we observe that while legislative issue salience was high for COVID-19 related topics (RQ1), this did not translate into similarly high levels of enacted legislation or policy change (RQ2). Finally, the policy learning question (RQ3) attempts to understand the extent to which enacted legislation made substantive changes to the public health system to improve response to future public health crises. Because the two most active areas of legislation were health and fiscal, but since fiscal actions were focused almost entirely on allocating federal stimulus and public health funds to stem the crisis, we again focus on health-related legislation for this final analysis.
RQ3: Were policy changes in U.S. states substantive in nature, focused on institutional changes to better respond to future public health crises?
32The 68 of 373 Public Health bills that were enacted by state legislatures include a wide range of subjects, from specific tools to make pandemic response more effective to simple instrumental uses of legislative power to constrain executive branch emergency powers. A subset of these statutes urged or made a disaster declaration (Alaska, Utah), extended declarations (Kentucky, Massachusetts, Michigan, Utah), or terminated emergency declarations (Pennsylvania, Wisconsin).
33New York and Connecticut initiated studies through legislation (New York: minority health impact, delivery of medical care; Connecticut: COVID-19 impact study). A handful of bills focused on the management of the pandemic through COVID-19 testing plans (California, Michigan), contract tracing and/or exposure notification (New York, California), and provision of personal protective equipment (Nevada). The Hawaii legislature recommended that the governor develop a task force to make recommendations about enforcement of emergency proclamations that mandated social distancing, face coverings, and prohibited gatherings.
- 2 We note that vaccinations are a separate sub-topic under Health that was not fully analyzed-–only l (...)
34Republican legislators authored public health bills related to vaccinations and immunizations that were enacted in four states (Indiana, New Hampshire, Georgia, South Carolina)2. Indiana’s immunization legislation banned any government entity from issuing or requiring an ’immunization passport’ (Act No. 1-2022). Enacted legislation in New Hampshire (Act No. 83) allows individuals to withdraw their vaccination status from the state immunization registry. Georgia enacted legislation that bans any state or local government from requiring vaccinations. South Carolina banned COVID-19 vaccination requirements by state and local governments, including local school districts, and legislated that first responders may not be terminated, lose work hours, or lose compensation based on their decision not to vaccinate. Further, the South Carolina legislature mandated that:
All persons shall be entitled to the full and equal enjoyment of the goods, services, facilities, privileges, advantages, and accommodations of any place of public accommodation without discrimination or segregation on the basis of the person's vaccination status.
35At least three states passed legislation focused on COVID-19 case and death count data. New Jersey enacted data-related legislation focused on publishing cases and deaths in long term care facilities (Act No. 2021-5). Hawaii enacted legislation about the release of COVID-19 cases in schools (SB 811), whereas Oregon’s legislation focused on COVID-19-related disclosures of identified data. The California general assembly passed legislation related to employee health and safety and small business income tax relief. California also enacted a bill titled “Public Health: COVID-19” that mandates local communities to disseminate information on their websites about state-wide orders and guidance to manage the pandemic.
36While most states did not hold statewide elections in 2021, New Jersey and Virginia did, pointing towards a potentially rich area of analysis related to institutional changes that allowed for safe elections during a public health crisis (Krieg & Lee, 2021; Tully, 2021). Additionally, Figures 3 and 4 indicate that higher capacity state legislatures may introduce and enact significantly different amounts of legislation than lower capacity states, as evidenced by California, Illinois, New York, and New Jersey being among the most active legislatures.
37While our research question asked whether public health capacity and institutions were strengthened as a result of COVID-19 related policy changes, the examples provided above and the patterns outlined throughout this analysis suggest that there was a variety of legislation introduced across the U.S. states, but a small minority of that legislation was enacted, and of those bills that were enacted related to public health, only a handful of policies sought to improve public health response through various predominant approaches such as data availability, generating statewide studies, and providing clarity on executive emergency powers. Alternatively, we saw numerous states regress in terms of their preparedness for a public health emergency in that they rescinded or limited executive emergency powers, prohibited the strongest public health requirements, and similar measures. This finding is important in that focusing event research is at times critiqued for assuming that policy learning and change moves governments towards more effective solutions and outcomes. The COVID-19 state-level legislative findings demonstrate that this is not always the case and that learning can occur in a way that leads to normatively inferior policy outputs and outcomes.
38This descriptive exploratory analysis of U.S. state-level legislative issue salience and policy change provides several insights into policy change, lessons from disaster, and the patterns observed across U.S. states during the COVID-19 pandemic. While issue salience, as measured by legislative activity, related to public health across multiple sectors (e.g., education, housing, health, etc.) was heightened after COVID-19 emerged as a global pandemic in early 2020 (RQ1), this did not translate into high levels of policy change (RQ2), as measured by policy adoption/enaction, in either public health or fiscal issue areas, which were the two most common areas of activity. There was, however, a wide array of foci across the states, which suggests that there is potential variation in policy change outputs, motivations, and eventual outcomes that may lead to increased public health preparedness in some states but decreased preparedness in others (RQ3). The implication for the literature on agenda setting, crises, and subnational governments is that crises may produce less consistent democratic governance during a crisis from state to state. More research is necessary to examine the extent to which this is relevant and the conditions under which it occurs.
39The summary of legislation introduced and enacted in U.S. states between 2020 and 2022 is useful in helping conceptualize what is still to be learned from the COVID-19 pandemic, particularly as scholars look to longer-term studies focused on the pandemic’s lasting effects on societies. The policy making activity during the pandemic marks a considerable amount of effort to confront an emergent and evolving public problem. All of this policy activity emerged during a period of highly polarized partisan politics. The policy activity and polarization in national and subnational politics cannot be overlooked as important factors for agenda change and learning during a crisis. We propose a set of research questions to guide future research and provide direction for the community of scholars intent on learning from and making sense of the politics and policy of the pandemic and similar crises.
40Based on the overview of legislative issue salience and policy change presented here, we believe that scholars should consider in-depth, longitudinal studies using mixed methods to capture both general trends and specific nuances of the legislation enacted. Questions that may motivate such studies include:
-
Are partisan bills substantively different from bipartisan bills that are introduced given the findings related to bipartisan success, or is it merely the nature of the state political divide as to which legislation is more successful?
-
Do fiscal policies in states simply funnel federal money to states or localities, or is there significant policy change happening through these legislative actions that is not observed in the policy text?
41Additionally, questions pertaining to the institutional and political environment are critical to explore so that scholars may understand the constraints imposed by such factors and not attribute policy change to erroneous variables. For example, there exist a myriad of datasets outside of the policy sciences measuring differences in state legislative professionalism (Squire, 2023) as well as state legislative effectiveness (Bucchianeri, Volden, Wisemen, 2024) that policy scholars may consider leveraging when assessing institutional and political factors. Questions that motivate such studies might include:
-
Are the proportions of bills that were enacted compared to those that were introduced different from state to state, and if so, are there features of the institutional or political environments in these states that would cause this to happen?
-
Are there dynamics between governors and state legislatures, or in the power granted to governors, that help predict which states introduce or enact more legislation?
-
Does the presence of an upcoming election change the nature of legislative and executive action during a crisis as it might during non-crisis times?
-
Does legislative capacity predict legislative action during a crisis as it does during routine legislative activity?
-
To what extent does state legislative professionalism or effectiveness influence policy learning and change in the aftermath of long duration disasters?
42Understanding the policy and public health outcomes of legislative action is also critical to developing a clearer sense of whether this activity had real consequences, either positive or negative. Questions that can initiate such studies include:
-
Some states mandated further studies of the public health responses to COVID-19, but does learning take place as a result of these studies and are policy changes made from those studies?
-
Did some states regress with regard to preparedness for future pandemics, and if so, what factors led this to happen beyond the simple (potential) partisanship explanation?
43Throughout this inquiry and others, our team has explored questions of learning in the aftermath of crisis. There is often a presumption of learning when we observe policy change, but we believe far more needs to be analyzed to understand if learning occurs and what factors influence such learning. Potential research questions in this vein include:
-
Does policy change represent learning, or are the changes observed simply examples of mimicking other like-minded states or passing of federal mandates?
-
What types of learning occurred in U.S. state legislatures regarding COVID-19, and can we begin to tease apart the mechanisms that caused learning?
-
To what extent do advocacy coalitions, policy entrepreneurs, and other manifestations of organized interests play a role in lesson learning, lesson transfer, and mimicry?
-
Did any states exhibit organizational learning evidenced by the creation or restructuring of public health organizations to better respond to pandemics?
-
Did the policy change during COVID-19 lead to normatively better public health outcomes?
44Finally, while we use the 50 U.S. states here to explore patterns that help us develop future research directions, the ‘laboratory of democracy’ that the U.S. states provide can help generate knowledge that can then be applied and tested beyond the U.S. context:
-
To what extent are the patterns of learning in the U.S. states applicable to other countries with nested systems of government?
-
What are the important similarities and differences in a comparative context?
45These questions - and many more - should explore the many nuances of agenda attention, policy change, and policy learning during and after the COVID-19 pandemic. While there was far too much tragedy that arose from the pandemic, the opportunities for public policy scholars to learn from the policy responses are unprecedented and potentially vital for both understanding the dynamics of policy change spurred by a crisis but also for understanding whether we are more prepared for the next global pandemic.
46This study represents a first attempt at describing subnational legislative issue salience, policy change, and policy learning during and as a result of a crisis. Further, it articulated a research agenda for understanding the longer-term effects of the COVID-19 pandemic in the United States. It builds upon prior work that looked at policy learning and executive action during the first year of the pandemic (Crow et al., 2023) and contributes to a larger study of pandemic-related policy learning and change. While the descriptive findings presented here provide some insight into legislative activity during the pandemic, future work must delve deeper into the nature of the policy changes, patterns among states, and influences over learning and change. Although lasting policy change would be required for substantive change to institutions of governance related to public health crises, the next step is to understand what those are, and then longitudinal studies could help understand if they actually improved public health outcomes as intended. These and other future directions provide a pathway for scholars of subnational policy processes to begin to understand the extent of COVID-19 or other emergent crises influences on public policy and public health.