Policy Uptake as Political Behavior: Evidence from the Affordable Care Act
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.
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Republicans assigned to the private website were 20 percentage points more likely to enroll in an insurance plan than Republicans assigned to the government website.
“Republicans assigned to the private website were 20 percentage points more likely to enroll in an insurance plan than Republicans assigned to the government website (see their figure 4 and the discussion on p. 764).”
From The Origins and Consequences of Affective Polarization in the United States (2019) · cites this paper as Lerman et al. (2017)
Republicans were less likely than Democrats to enroll in health insurance exchanges set up by the Affordable Care Act.
“On the patient side, Lerman et al. (2017) leverage longitudinal data and find that Republicans were less likely than Democrats to enroll in health insurance exchanges set up by the Affordable Care Act.”
From The Origins and Consequences of Affective Polarization in the United States (2019) · cites this paper as Lerman et al. (2017)
The website had no effect on the behavior of Democrats or Independents, but had an enormous effect on Republicans.
“While the website had no effect on the behavior of Democrats or Independents, it had an enormous effect on Republicans.”
From The Origins and Consequences of Affective Polarization in the United States (2019) · cites this paper as Lerman et al. (2017)
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- Authors
- LERMAN, A. E., SADIN, M. L., & TRACHTMAN, S.
- Affiliations
- University of California, Berkeley (US)
- Corresponding author
- LERMAN, AMY E.
- SADIN, MEREDITH L.
- TRACHTMAN, SAMUEL
- Venue
- American Political Science Review
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-08-22
- Volume
- 111
- Issue
- 4
- Pages
- 755-770
- ISSN
- 0003-0554 (ISSN-L)
- 1537-5943
- OpenAlex
- W2747062776
- Cited by
- 178
- References
- 0
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 8 · 2023: 25 · 2022: 29 · 2021: 24 · 2020: 52 · 2019: 13 · 2018: 9 · 2017: 4
- FWCI
- 103.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Political Science Review (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Political Science and International Relations › Electoral Systems and Political Participation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Political Science and International Relations › Social Policy and Reform Studies
- Keywords
- policy uptake, Affordable Care Act, partisanship, political behavior, health insurance enrollment, health insurance exchanges, public policy attitudes
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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