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The Inequality of Policy Effects: Policy Feedbacks and Health Care Reform

Thu, August 31, 2:00 to 3:30pm, Parc 55, Mission I


Policy feedback research has long been interested in how policy effects influence political and economic inequality. Prior research has pointed to racial, income, and gender disparities in policy feedbacks. Nonetheless, the analysis remains limited in three respects. First, prior research has given insufficient attention to the conditional nature of policy effects. Second, we know little about the relative significance of differential policy effects across gender, race, and income. Third, we need to understand better the mechanisms that influence policy effects on political behavior and public opinion.

We aim to address these challenges by using a unique panel study to examine the implementation since 2010 of the Affordable Care Act (ACA). Did this landmark social policy dislodge, reinforce, or have no effect on attitudes associated with civic capacities and public evaluations of health reform across race, gender, and income?

The proposed paper analyzes four waves that begin in 2010 shortly after the law’s passage and continues in 2012, 2014, and 2016. This unique panel study positions us to measure patterns across socio-economic sub-groups as well as change. In particular, we will focus on tracking the frequency of policy feedbacks on discrete sub-groups and their differential impacts across groups. In addition, we examine whether the policy feedbacks on discrete social groups are progressive in expanding support for specific new health programs or regressive in reducing support for these government interventions.

Republican lawmakers are committed to repealing the ACA. This is not surprising given the intense partisan divisions over the law’s passage. What is striking, however, is the commitment to replacing the law in a way that sustains the law’s expanded coverage and greater security for reliable health insurance. Policy feedbacks provide a crucial context to explain the Republican commitment to replace the ACA rather than terminate it; our proposed paper will explore whether differential sub-group support may help to account for the GOP’s surprising commitment to health reform.


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