The ACA and the Politics of Deservingness: Policy Feedback and Interactions

• In Event: Public Opinion and Health Politics: Policy Feedback and Misinformation

Abstract

Much attention has been paid to disparities in the Affordable Care Act’s implementation as a result of state decisions regarding whether and how to expand Medicaid or regulate insurance markets. But while some scholars have described the different policy feedback effects created by the ACA’s Medicaid expansion and insurance market reforms, respectively, there has been little analysis of how these divergent feedback effects interact with one another. Drawing on polling data and public opinion research, this paper explores how those with private insurance under the ACA view those on Medicaid, and vice versa. In doing so, this study furthers our understanding of the relationship between policy design and policy feedback, particularly for complex policies like the ACA that achieve their goals through multiple means that vary based on different target populations (Schneider and Ingram, 1993), as well as literature on the submerged state (Mettler 2011) and policy durability (Patashnik 2008). These insights also have implications for health reform moving forward

Author

• Sean Miskell, Syracuse University