The Medicaid Expansion and Attitudes toward the Affordable Care Act: Testing for a Policy Feedback on Mass Opinion

The Affordable Care Act and the Diffusion of Policy Feedback: The Case of Medicaid Work Requirements

“…Julianna Pacheco, Jake Haselswerdt, and Jamila Michener (2020) examine the impact of ACA implementation on partisan polarization in support for the ACA. Consistent with other studies of ACA feedback effects on voter attitudes (Hopkins and Parish 2018;Lerman and McCabe 2017), they find that ACA implementation did have a significant effect on ACA support, but the direction of the effect varied based on the state partisan environment.…”

Economic influences on population health in the United States: Toward policymaking driven by data and evidence

“…These dynamics were particularly salient in the 2016 presidential election, in which areas with worsening health outcomes saw increased support for Donald Trump [154,155], a candidate who campaigned, for example, on deconstructing the Affordable Care Act and reducing environmental regulation. On the other hand, expansion of the Medicaid program, which has shown to improve both health and economic outcomes among low-income US residents [99,119,120], was associated with increased support for the program [156] and greater voter turnout [157]. Incorporating the study of such "political feedback loops" into analyses of the effects of social and economic policies will thus be important to fully elucidate their long-run economic and health consequences.…”

Medicaid Expansion and the Political Fate of the Governors Who Support It

“…They focused their attention on newly enrolled beneficiaries in expansion states and found that they became significantly more supportive of Medicaid as a result of their participation in the program. Finally, utilizing data from 175 unique surveys, Hopkins and Parish () found that support for the ACA increased in Medicaid expansion states, particularly among lower income citizens.…”

“…A number of recent studies have utilized a policy feedback framework to understand the feedback effects of healthcare reform. Several of these studies have focused on the impact of Obamacare on potential self‐reinforcing feedback effects operating through the political attitudes and behavior of program targets (Campbell, ; Chattopadhyay, ; Haselswerdt, ; Hopkins & Parish, ; Lerman & McCabe, ). Despite differences in data sources and the operationalization of the target population, all but one of these studies (Chattopadhyay, ) finds evidence of positive feedback effects.…”

“…In this paper, we extend this literature on the policy feedback effects of the ACA by estimating the effect of Medicaid expansion on public support for the state actor most closely associated with the responsibility for the expansion decision—the governor (Béland, Rocco, & Waddan, ). To date, research on the policy feedback effects of the ACA has generally been limited to the effects of reform on public support for the policy (Chattopadhyay, ; Hopkins & Parish, ; Lerman & McCabe, ; Stances & Clinton, ). While this connection between policy change and public opinion represents a central assumption of policy feedback theory, what makes the policy feedback framework so valuable to policy theorists is the additional assumption that these political effects will have important implications for future policy development (Béland, ; Pierson, ).…”