Health Reform, Endowment Effects, and Racism: An Experiment with the ACA

• In Event: Race, Health Policy, and Disparities in Political Voice

Abstract

Arguably, the Affordable Care Act has been the most consequential piece of legislation that made it out of Congress over the past half-century. Indeed, more than a decade after its passage, its future remains marred in the court system. American public opinion has moved very little over the same time frame and it remains starkly divided among partisan lines. Yet even on this highly political issue, framing effects may play an important role. This particularly holds in how closely health reform may be associated with the former president.

To investigate this issue, we fielded a large nationally representative survey that included an experiment that primed respondents in three ways. First, in order to assess the effects of wording on public opinion about the ACA we presented respondents with alternating versions of “health reform,” the “Affordable Care Act,” and “Obamacare.” Second, given the abundance of research highlight the racialized politics of the ACA, we supplemented some of these frames with pictures of President Obama. This allows us to test whether further highlighting the connection between the ACA and President Obama substantively increases the previous effects. Thirdly, we presented half of our respondents with frames focused on potentially losing the gains made from the ACA through the lawsuit currently in front of the Supreme Court (instead of simply asking them about the ACA). This allows us to assess the estimate of the endowment effect associated with the ACA.

Overall, our work builds on previous work on public opinion about the Affordable Care Act. However, we substantially extend the literature by exploring the important graphical dimension of racism as well as offering the first assessment of endowment effects related to the ACA.

Authors

• Simon F. Haeder, The Pennsylvania State University

• Steven M. Sylvester, Utah Valley University