The Power of a Tweet? Presidential Communication and the Affordable Care Act

• In Event: Presidential Leadership and the Makings of Public Policy

Abstract

Few laws have been as controversial as the Affordable Care Act in American public opinion for a sustained amount of time. More than a decade after its passage, the ACA continues to split Americans and elicit strong responses in public discourse. At the same time, President Trump has consistently reiterated his opposition if not hostility to the Obama Administration’s landmark achievement. One of his preferred venues to do so, has been Twitter. While there is a large amount of research on the determinants of public opinion about the ACA there is relatively little research specifically focused on the impact of President Trump’s tweets. We argue that communications via Twitter is distinctively different from other forms of media because it allows the president to reach out to the American public directly and frequently without any media filter. We thus descriptively investigated the extent of the president’s Twitter usage related to the ACA over the course of his presidency. We then developed and fielded a nationally representative survey of 2,481 Americans that included a survey experiment based on the president’s communication via Twitter. This experiment assesses the effect of five different scenarios of the president’s tweets on perceptions of the ACA as well as the ACA’s effects on healthcare access, costs, and quality. Finally, we assess the effect of the president’s tweets on the public’s relative trust in the two major parties to handle health care issues.

Authors

• Simon F. Haeder, The Pennsylvania State University

• Jacqueline M. Chattopadhyay, University of North Carolina at Charlotte