Ten Years of Messaging about the Affordable Care Act in Advertising and News Media: Lessons for Policy and Politics

2020 ◽  
Vol 45 (5) ◽  
pp. 711-728 ◽  
Author(s):  
Sarah E. Gollust ◽  
Erika Franklin Fowler ◽  
Jeff Niederdeppe
Keyword(s):  
Affordable Care Act ◽  
News Media ◽  
Health Reform ◽  
Access To Health ◽  
The Us ◽  
Political Ads ◽  
The Affordable Care Act ◽  
The Law ◽  
And Behavior ◽  
Attitudes And Behavior

Abstract Messaging about the Affordable Care Act (ACA) has seemingly produced a variety of outcomes: millions of Americans gained access to health insurance, yet much of the US public remains confused about major components of the law, and there remain stark and persistent political divides in support of the law. Our analysis of the volume and content of ACA-related media (including both ads and news) helps explain these phenomena, with three conclusions. First, the information environment around the ACA has been complex and competitive, with messaging originating from diverse sponsors with multiple objectives. Second, partisan cues in news and political ads are abundant, likely contributing to the crystallized politically polarized opinion about the law. Third, partisan discussions of the ACA in political ads have shifted in volume, direction, and tone over the decade, presenting divergent views regarding which party is accountable for the law's successes (or failures). We offer evidence for each of these conclusions from longitudinal analyses of the volume and content of ACA messaging, also referencing studies that have linked these messages to attitudes and behavior. We conclude with implications for health communication, political science, and the future outlook for health reform.

What Health Reform Tells Us about American Politics

2020 ◽  
Vol 45 (4) ◽  
pp. 581-593
Author(s):  
Lawrence R. Jacobs ◽  
Suzanne Mettler
Keyword(s):  
Medical Care ◽  
Affordable Care Act ◽  
Health Reform ◽  
American Politics ◽  
Political Debate ◽  
Initial Implementation ◽  
The Affordable Care Act ◽  
The Law ◽  
The Right ◽  
Over Time

Abstract The passage and initial implementation of the Affordable Care Act (ACA) were imperiled by partisan divisions, court challenges, and the quagmire of federalism. In the aftermath of Republican efforts to repeal the ACA, however, the law not only carries on but also is changing the nature of political debate as its benefits are facilitating increased support for it, creating new constituents who rely on its benefits and share intense attachments to them, and lifting the confidence of Americans in both their individual competence to participate effectively in politics and that government will respond. Critics from the Left and the Right differ on their favored remedy, but both have failed to appreciate the qualitative shifts brought on by the ACA; this myopia results from viewing reform as a fixed endpoint instead of a process of evolution over time. The result is that conservatives have been blind to the widening network of support for the ACA, while those on the left have underestimated health reform's impact in broadening recognition of medical care as a right of citizenship instead of a privilege earned in the workplace. The forces that constrained the ACA's development still rage in American politics, but they no longer dictate its survival as they did during its passage in 2010.

Lost in the ACA: Bit Parts in a Landmark Law

2020 ◽  
Vol 45 (4) ◽  
pp. 533-545
Author(s):  
John E. McDonough
Keyword(s):  
Health Policy ◽  
Affordable Care Act ◽  
Health Reform ◽  
Comprehensive Health ◽  
The Affordable Care Act ◽  
The Law

Abstract The Affordable Care Act (ACA) is a mosaic across a spectrum of health policy domains. The law contains hundreds of smaller and mostly unnoticed reforms aimed at nearly every segment of American health policy. Ten years later, these provisions include successes, failures, and mixed bags, which should be considered in any full assessment of the ACA. This article examines 11 from each of these 3 categories, drawn from 9 of the ACA's 10 titles. These mininarratives deepen recognition that the ACA is our best example of comprehensive health reform and defies simplistic judgments.

Archived Attributes: An Internet-Text Approach to Measuring Legislator Attitudes and Behavior

2020 ◽  
pp. 1-8
Author(s):  
Emily Kalah Gade ◽  
Sarah Dreier ◽  
John Wilkerson ◽  
Anne Washington
Keyword(s):  
Cost Effective ◽  
Science Research ◽  
Religious Rhetoric ◽  
The Internet ◽  
Internet Archive ◽  
Scientific Analysis ◽  
The Us ◽  
And Behavior ◽  
Attitudes And Behavior ◽  
Time Invariant

Abstract The Internet Archive curated a 90-terabyte sub-collection of captures from the US government's public website domain (‘.gov’). Such archives provide largely untapped resources for measuring attributes, behaviors and outcomes relevant to political science research. This study leverages this archive to measure a novel dimension of federal legislators' religiosity: their proportional use of religious rhetoric on official congressional websites (2006–2012). This scalable, time-variant measure improves upon more costly, time-invariant conventional approaches to measuring legislator attributes. The authors demonstrate the validity of this method for measuring legislators' public-facing religiosity and discuss the contributions and limitations of using archived Internet data for scientific analysis. This research makes three applied methodological contributions: (1) it develops a new measure for legislator religiosity, (2) it models an improved, more comprehensive approach to analyzing congressional communications and (3) it demonstrates the unprecedented potential that archived Internet data offer to researchers seeking to develop meaningful, cost-effective approaches to analyzing political phenomena.

After the Affordable Care Act: Health Reform and the Safety Net

2016 ◽  
Vol 44 (4) ◽  
pp. 585-588
Author(s):  
Peter Shin ◽  
Marsha Regenstein
Keyword(s):  
Health Care ◽  
Community Health ◽  
Affordable Care Act ◽  
Health Reform ◽  
Community Health Centers ◽  
Safety Net ◽  
Public Hospitals ◽  
Health Centers ◽  
Safety Net Providers ◽  
The Affordable Care Act

Two major safety net providers – community health centers and public hospitals – continue to play a key role in the health care system even in the wake of coverage reform. This article examines the gains and threats they face under the Affordable Care Act.

Insurance Type and Access to Health Care Providers and Appointments Under the Affordable Care Act

Medical Care ◽  
2018 ◽  
Vol 56 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Héctor E. Alcalá ◽  
Dylan H. Roby ◽  
David T. Grande ◽  
Ryan M. McKenna ◽  
Alexander N. Ortega
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Providers ◽  
Insurance Type ◽  
Access To Health ◽  
The Affordable Care Act

What Is the Affordable Care Act a Case of? Understanding the ACA through the Comparative Method

2020 ◽  
Vol 45 (4) ◽  
pp. 677-691
Author(s):  
Holly Jarman ◽  
Scott L. Greer
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
Affordable Care Act ◽  
Strong Support ◽  
The United States ◽  
The Us ◽  
The Affordable Care Act ◽  
Shed Light ◽  
The Welfare State

Abstract International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more to international conversations about health care and the welfare state. After introducing the concept of casing—asking what the Affordable Care Act (ACA) might be a case of—the authors discuss different “casings” of the ACA: complex legislation, path dependency, demos-constraining institutions, deep social cleavages, segmentalism, or the persistence of the welfare state. Each of these pictures of the ACA has strong support in the US-focused literature. Each also cases the ACA as part of a different experience shared with other countries, with different implications for how to analyze it and what we can learn from it. The final section discusses the implications for selecting cases that might shed light on the US experience and that make the United States look less exceptional and more tractable as an object of research.

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