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Policy Uptake as Political Behavior: Evidence from the Affordable Care Act

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  • LERMAN, AMY E.
  • SADIN, MEREDITH L.
  • TRACHTMAN, SAMUEL

Abstract

Partisanship is a primary predictor of attitudes toward public policy. However, we do not yet know whether party similarly plays a role in shaping public policy behavior, such as whether to apply for government benefits or take advantage of public services. While existing research has identified numerous factors that increase policy uptake, the role of politics has been almost entirely overlooked. In this paper, we examine the case of the Affordable Care Act to assess whether policy uptake is not only about information and incentives; but also about politics. Using longitudinal data, we find that Republicans have been less likely than Democrats to enroll in an insurance plan through state or federal exchanges, all else equal. Employing a large-scale field experiment, we then show that de-emphasizing the role of government (and highlighting the market's role) can close this partisan gap.

Suggested Citation

  • Lerman, Amy E. & Sadin, Meredith L. & Trachtman, Samuel, 2017. "Policy Uptake as Political Behavior: Evidence from the Affordable Care Act," American Political Science Review, Cambridge University Press, vol. 111(4), pages 755-770, November.
    • Handle: RePEc:cup:apsrev:v:111:y:2017:i:04:p:755-770_00
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    Cited by:

    1. Allcott, Hunt & Boxell, Levi & Conway, Jacob & Gentzkow, Matthew & Thaler, Michael & Yang, David, 2020. "Polarization and public health: Partisan differences in social distancing during the coronavirus pandemic," Journal of Public Economics, Elsevier, vol. 191(C).
    2. Richard Domurat & Isaac Menashe & Wesley Yin, 2019. "The Role of Behavioral Frictions in Health Insurance Marketplace Enrollment and Risk: Evidence from a Field Experiment," NBER Working Papers 26153, National Bureau of Economic Research, Inc.
    3. Niam Yaraghi & Darrell M West & Ram D Gopal & Ram Ramesh, 2020. "(How) did attack advertisements increase Affordable Care Act enrollments?," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-20, February.
    4. Briguglio, Marie & Delaney, Liam & Wood, Alex, 2018. "Partisanship, priming and participation in public-good schemes," European Journal of Political Economy, Elsevier, vol. 55(C), pages 136-150.
    5. Syon P. Bhanot & Daniel J. Hopkins, 2020. "Partisan polarization and resistance to elite messages: Results from survey experiments on social distancing," Journal of Behavioral Public Administration, Center for Experimental and Behavioral Public Administration, vol. 3(2).
    6. Masha Krupenkin & David Rothschild & Shawndra Hill & Elad Yom-Tov, 2019. "President Trump Stress Disorder: Partisanship, Ethnicity, and Expressive Reporting of Mental Distress After the 2016 Election," SAGE Open, , vol. 9(1), pages 21582440198, March.

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