Stability and policy threats: US public opinion after a decade of the Affordable Care Act

IF 1.7 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH World Medical & Health Policy Pub Date : 2024-04-15 DOI:10.1002/wmh3.609
Simon F. Haeder, Steven Sylvester
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Abstract

The Affordable Care Act (ACA) continues to shape US politics at the elite level. We know less about whether this conflict still carries over to the broader public. Moreover, we know little about the degree to which the conflict reaches into its various policies and whether the policy threats to the ACA can affect public opinion. We fielded a large, and demographically diverse survey of US adults using Lucid (N = 6066) from July 8–21, 2020. The survey contained an experiment that introduced the topic to respondents as the 2010 health reform law, the ACA, or Obamacare and at times highlighted the potential undoing of the ACA by the US Supreme Court. Analyses were conducted using Ordinary Least Squares regression. Our findings indicate that perceptions of the ACA differ substantial based on partisanship and racial prejudice. Framing still matters in the minds of Americans and their perception of health reforms in general and its individual components by extending these differences. However, we find only very limited evidence for changes to public attitudes related to the policy threat of the Supreme Court ruling the ACA constitutional in California v. Texas. The ACA remains a political battleground in the minds of Americans. The politics of the ACA continue to be shaped by perceptions of race and partisanship.
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稳定性与政策威胁:平价医疗法案》实施十年后的美国公众舆论
平价医疗法案》(ACA)继续影响着美国精英阶层的政治。我们对这一冲突是否仍会波及更广泛的公众知之甚少。此外,我们对这一冲突在多大程度上影响到各种政策,以及对《可负担医疗法案》的政策威胁是否会影响公众舆论也知之甚少。2020 年 7 月 8 日至 21 日,我们使用 Lucid 对美国成年人进行了一次大规模的人口统计多元化调查(N = 6066)。调查包含一个实验,向受访者介绍 2010 年医改法、ACA 或奥巴马医改,并不时强调美国最高法院可能会撤销 ACA。分析采用普通最小二乘法回归。我们的研究结果表明,基于党派和种族偏见,人们对 ACA 的看法大相径庭。通过扩大这些差异,框架在美国人的心目中仍然很重要,也影响着他们对总体医疗改革及其各个组成部分的看法。然而,我们发现只有非常有限的证据表明,公众态度的变化与最高法院在加利福尼亚州诉得克萨斯州一案中裁定 ACA 符合宪法的政策威胁有关。在美国人的心目中,ACA 仍然是一个政治战场。对种族和党派的看法继续左右着 ACA 的政治走向。
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来源期刊
World Medical & Health Policy
World Medical & Health Policy PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.10
自引率
7.30%
发文量
65
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