The research team led by Sarah Gollust (University of Minnesota) and Erika Franklin Fowler (Wesleyan University) released an article detailing findings from their SHARE-funded research in the Fall 2016 of the Journal of Health Politics, Policy and Law.
Research Question
The paper, with lead authorship from Dr. Fowler, examines the extent to which exposure to locally broadcast ACA-related media messages affected the public’s perception of the ACA during the first ACA open enrollment period. Specifically, the research team wanted to know whether there was a relationship between the volume of messaging to which the public was exposed and the public’s perceptions of how informed they were about, and favorable toward, the ACA in October 2013.
Data and Methods
The researchers estimated exposure to media messaging by quantifying volumes of messaging—including messaging in the form of both paid health insurance and political advisements and news media stories—at the media market level using Kantar Media/CMAG data from the Wesleyan Media Project. They then merged this data with nationally representative data from the October 2013 Kaiser Health Tracking Poll that they weighted to match US population characteristics using the 2011 American Community Survey.
The researchers created individually varying exposure measures by accounting for both what media content was available to an individual in a particular geographic media market and the extent to which the respondent was likely to have paid attention to the available media content. To accomplish this, the researchers matched each survey respondent to the media market in which the respondent resided using county indicators from the Kaiser data, and they used responses to three survey items about domestic policy to create a scale estimating the amount of available media volume to which a respondent likely paid attention.
The authors estimated regression models of their two key outcomes (i.e., the public’s perceptions about how informed they were about the ACA and the public’s favorability toward the ACA) on several media exposure variables: volume of news coverage on the ACA; volume of ACA-related insurance advertising; and volume of ACA-related political advertising. They also tested for differential effects based on partisanship by including indicator variables for respondent political party affiliation (Democrat, Republican, or Independent).
| Findings |
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The authors found that in areas with higher volumes of insurance advertising and local news coverage, survey respondents were more likely to perceive themselves as being informed about the ACA, regardless of political affiliation. Estimated exposure to political ads about the ACA is not, however, associated with perceptions of being well-informed. Higher media messaging exposure (regardless of type) was also associated with favorability to the ACA, with the direction of this relationship varying by the partisan affiliation of the respondent, such that higher messaging exposure among Democrats is associated with increasingly favorable views of the law, while higher messaging exposure among Independents and Republicans is associated with less favorable perceptions of the law relative to Democrats. |
Discussion
The authors note that the key findings from this analysis have implications for ACA outreach, pointing out that a sense of being informed about the law could translate into actual enrollment gains resulting from exposure to more insurance advertising—a possibility that the research team is currently investigating.
The findings also suggest that even neutrally-presented ACA-related information may be processed differently according to the partisanship of the viewer/listener. The authors declare that the extent to which this partisan perceptual bias of information about health policy issues continues into the future is an important consideration for those studying health politics.
Attending APPAM's 2016 Fall Research Conference?
Dr. Gollust will be speaking about these findings at APPAM on Saturday, November 5th, at 9:30 a.m. in the Cardozo Room of the Washington Hilton. Learn more.
About the SHARE Grant Program
SHARE is a Robert Wood Johnson Foundation (RWJF) grant program that funds rigorous research on health reform at the state level, including state implementation of national reform. SHARE is housed at and operated by SHADAC in the Division of Health Policy and Management, University of Minnesota, School of Public Health.