Federalism and Public Opinion on Healthcare: The Design of the Affordable Care Act's Insurance Exchanges and User Experience with the Exchanges.
Using original survey data and the 2016 American National Election Study (ANES), we examine the effects of healthcare exchange type and user experience on individuals' support for the Affordable Care Act (ACA). States are divided into three different types of ACA exchange implementation regimes: sta...
| Published in: | Publius: The Journal of Federalism Vol. 50; no. 1; pp. 55 - 81 |
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| Main Authors: | , , |
| Format: | Article |
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Oxford University Press / USA
Winter2020
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=140686731&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 140686731 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00485950 UBL jtl: Publius: The Journal of Federalism issn: 00485950 maglogo: N pubinfo: dt: Winter2020 vid: 50 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 140686731 10.1093/publius/pjz002 ppf: 55 ppct: 26 formats: tig: atl: Federalism and Public Opinion on Healthcare: The Design of the Affordable Care Act's Insurance Exchanges and User Experience with the Exchanges. aug: au: Liebertz, Scott Bunch, Jaclyn Shaw, Thomas affil: University of South Alabama su: United States Public opinion Health policy Citizen satisfaction Federal government of the United States Patient Protection & Affordable Care Act Health policy laws sug: subj: Public opinion Health policy Citizen satisfaction United States Administration of Public Health Programs Federal government of the United States Patient Protection & Affordable Care Act Health policy laws ab: Using original survey data and the 2016 American National Election Study (ANES), we examine the effects of healthcare exchange type and user experience on individuals' support for the Affordable Care Act (ACA). States are divided into three different types of ACA exchange implementation regimes: state-run exchanges, federally operated exchanges, and mixed state-federal exchanges. We hypothesize that individuals in states running their own exchanges will demonstrate greater support for the ACA and individuals with experience using the exchanges will exhibit greater levels of support for the ACA. Results from a survey conducted in 2016 in Alabama (a federal exchange), Kentucky (a state exchange at the time), and Arkansas (a mixed state-federal exchange) support these hypotheses. These findings are also confirmed using national data from the ANES. We therefore provide evidence that local control over healthcare implementation leads to better outcomes in terms of citizen satisfaction and that citizens who have experience with exchanges established by the ACA are more likely to feel positively about the law. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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