Does Policy Impact Voting Behavior?: How the Affordable Care Act Has Impacted Electoral Outcomes

Abstract

After its passage in 2010, the Affordable Care Act (ACA) became a lightening rode around which each major political party rallied either in fierce defense or fervent opposition. However, as individuals have begun to feel the impacts of the policy in their daily lives, the popularity of the program has slowly increased. After unsuccessful attempts to repeal the ACA, the Democratic Party chose to center their 2018 midterm campaign strategy around protecting the law. After their sweeping success, many journalists published articles analyzing the effectiveness of this choice. Using data from the American National Election Study’s cumulative data set, this study analyzes the relationship between the Affordable Care Act and electoral outcomes in more depth. Specifically, I have used data from the 2008, 2012, and 2016 presidential elections to control for the impact of demographic and other political factors in order to evaluate if attitudes towards health care (particularly the Affordable Care Act) impact voting behavior. The results of the probit models indicate that opinions on government involvement in the health care system impact voters’ choice of presidential candidate. Surprisingly, multivariate analyses show that the more likely a voter is to support government involvement in the health care system, the more likely they are to vote for a Republican. This could be due to the fact that there are several government health care plans that disproportionally serve seniors, who are more likely to support conservative candidates. Other policy areas that consistently impacted one’s choice of presidential candidate in a statistically significant manner were attitudes towards government spending, Muslims, the LGBTQ community, and feminists. If it is the case that individuals who traditionally vote Republican are also in favor government involvement in health care, than pledging to protect the Affordable Care Act could continue to present opportunities for Democrats to swing voters that may not traditionally support the party.