Are press depictions of Affordable Care Act beneficiaries favorable to policy durability?

Abstract

ABSTRACT. Background: If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability-meaning both avoidance of outright retrenchment and fidelity to its policy aims-is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability.Questions: This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary ''deservingness'' in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Methods Implications and Conclusions:Existing literature suggests that these portrayal patterns may both support and limit ACA durability. In favor of durability is that ACA beneficiaries are depicted in terms that have been associated with deservingness in past American social policy-particularly being cast as workers and insiders. Yet, the results also give three reasons for caution. First, ACA insurance-losers are also portrayed as deserving. Second, it is unclear how the portrayal patterns found may impact the durability of the ACA's efforts to cut insurance disparities by age, health status, and especially race/ethnicity. Third, portrayals' strong casting of beneficiaries as workers, and limited attention to beneficiaries' economic heterogeneity and to young adults, may do little to help cultivate beneficiary political engagement around the ACA.

Is the ACA's Dependent Coverage Provision Generating Positive Feedback Effects Among Young Adults?

“…“Social Security gave seniors a political identity as program beneficiaries” and thereby enabled their mobilization (Campbell, , p. 92). The DCP conceivably could do the same for those under 26 (Chattopadhyay, , p. 13). While age alone is an imperfect way to identify DCP beneficiaries, as not all 19–25‐year‐olds can in practice obtain dependent coverage, political parties have data that support targeted messaging during elections (e.g., Ridout, Franz, Goldstein, & Feltus, ), and such data are also used in post‐election administrative functions (Hersh, , pp.…”

Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

“…It is important to assess and understand why and how open data and information access is needed in the context of health and diseases epidemics. Also, what capacity development and training are needed to translate these various valuable datasets and database assets if freely available into knowledge-based innovations needed to revolutionize Africa and global health capabilities, and opportunities to prevent and control emerging epidemics and infectious diseases of poverty 1 , 3 , 13 , 14 .…”

“…In recent times, the persistence and unprecedented emergence of rising epidemics and infectious diseases in Africa and worldwide triggered numerous public health declarations of international concern 1 . These local and global uncertainties and potential consequences have prompted questions and reflections on the usefulness and implications of unlocked and unprocessed available massive database resources from different national, regional and international funded projects overtime in low and middle income countries (LMICs) and particularly in Africa.…”

“…It is critical that the information is used in an equitable, ethical and transparent manner. Operational research projects in libraries, national archiving, journals, local and international 1 , 4 scholarly institutions and centers are partially or yet to be fully tapped into maximizing and ensuring improvements of health and disease information, knowledge and empowerment for all generations 5 .…”

“…Increasing unrestricted and FOA use or reuse as well as timely reporting or communication capabilities strategies are urgently needed in promoting and scaling up data and information sharing and exchange between African researchers, partners and collaborators 1 , 3 , 12 , 13 . The strength of scaling FOA in developing countries will entail but not limited to: 1) increasing real time and effective knowledge- or evidence-based translation of proven and validated approaches, 2) strategies and tools in strengthening health systems and revamping early and timely access to much needed information by policy-makers, and 3) enhanced guided health financing and capacity development by health institutions and related stakeholders, and strengthening contextual programs and activities planning, transparency and accountability.…”