Racial Attitudes and Support for the Affordable Care Act among U.S. Protestants
Berkeley Franz, Ph.D., Assistant Professor of Community-based Health, Ohio University Heritage College of Osteopathic Medicine
In the United States, support for health policy change has historically been deeply divided among partisan lines. The Affordable Care Act (ACA), the Obama’s administrations landmark health care law, introduced many important changes for medical practice and public health, but faced important political barriers to reach implementation. Despite early objections to contraceptive coverage in the publicly available insurance plans by religious groups, we know very little about how religion shapes attitudes toward this and other health policies. Given available evidence regarding the role that religious attendance plays in favoring individualism or structuralism in policy preferences, we question whether theological beliefs and religious messages received in worship settings may impact views toward the ACA. In particular, we extend previous research on the religious and cultural toolkits fostered within religious traditions to views on health care policy change. Using Pew Research Center’s Voter Attitudes Survey from 2012, we assess support for the ACA during the year it was implemented and in which the Supreme Court upheld the constitutionality of key provisions such as the individual mandate. Using logistic regression modeling, we find that White Evangelicals, independent of partisan affiliation, are more likely to reject the ACA and subsequent Supreme Court decision as compared to Black Protestants. Importantly, we find that support for the ACA weakens with increasing religious attendance, suggesting that responses to this law are shaped within religious organizations. In our discussion, we consider the ways in which religious leaders frame political messages in different Protestant traditions. Given the potential for the ACA to improve access to health care among Americans and address long-standing racial health disparities, our findings provide insight into how support for this policy is fostered within different religious traditions. Understanding how individualism and structuralism are related to theological beliefs will be critical for future discussions about health care policy in the United States.