Ten years of messaging about the affordable care act in advertising and news media: Lessons for policy and politics

Sarah E. Gollust, Erika Franklin Fowler, Jeff Niederdeppe

Research output: Contribution to journalArticlepeer-review

Abstract

Messaging about the Affordable Care Act (ACA)has seemingly produced a variety of outcomes: Millions ofAmericans gained access to health insurance, yet much of theUS public remains confused about major components of the law, and there remain stark and persistent political divides in support of the law. Our analysis of the volume and content of ACA-related media (including both ads and news) helps explain these phenomena, with three conclusions. First, the information environment around theACA has been complex and competitive, with messaging originating from diverse sponsors with multiple objectives. Second, partisan cues in news and political ads are abundant, likely contributing to the crystallized politically polarized opinion about the law. Third, partisan discussions of the ACA in political ads have shifted in volume, direction, and tone over the decade, presenting divergent views regarding which party is accountable for the law's successes (or failures). We offer evidence for each of these conclusions from longitudinal analyses of the volume and content of ACA messaging, also referencing studies that have linked these messages to attitudes and behavior. We conclude with implications for health communication, political science, and the future outlook for health reform.

Original languageEnglish (US)
Pages (from-to)711-728
Number of pages18
JournalJournal of health politics, policy and law
Volume45
Issue number5
DOIs
StatePublished - Oct 2020
Externally publishedYes

Bibliographical note

Funding Information:
Sarah E. Gollust is associate professor of health policy and management at the University of Minnesota and is an associate director of the Robert Wood Johnson Foundation Interdisciplinary Research Leaders. Her research examines the influence of the media and public opinion in the health policy process, the dissemination of research into policy making, and the politics of health policy. Her research has been funded by the National Institutes of Health, the Robert Wood Johnson Foundation, the Russell Sage Foundation, and the American Cancer Society. sgollust@umn.edu Erika Franklin Fowler is associate professor of government at Wesleyan University and codirector of the Wesleyan Media Project. Her research examines the content and effect of media messaging in electoral and health policy contexts. Her work has appeared in such outlets as the American Journal of Political Science, Journal of Communication, and Health Affairs. Her research in recent years has been funded by the Robert Wood Johnson Foundation, the John S. and James L. Knight Foundation, the Russell Sage Foundation, and the American Cancer Society.

Funding Information:
Jeff Niederdeppe is associate professor in the Department of Communication at Cornell University. His research examines the mechanisms and effects of mass media campaigns, strategic health messages, and news coverage in shaping health behavior, health disparities, and social policy. He has published more than 125 articles in communication, public health, health policy, and medical journals, and his work has been funded in recent years by the National Institutes of Health, the National Science Foundation, the Environmental Protection Agency, and the Robert Wood Johnson Foundation.

Funding Information:
We thank Colleen Bogucki, Margaret Tait, Laura Baum, and the team of undergraduate research assistants from the Wesleyan Media Project. We also acknowledge funding from the Robert Wood Johnson Foundation (grant nos. 73619, 75347, and 77117) and the Russell Sage Foundation (grant no. 1808-08181). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the Russell Sage Foundation or the Robert Wood Johnson Foundation.

Keywords

  • Advertising
  • Affordable Care Act
  • Health insurance
  • Media
  • Politics

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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