Does Question Wording Predict Support for the Affordable Care Act? An Analysis of Polling During the Implementation Period, 2010–2016
Does Question Wording Predict Support for the Affordable Care Act? An Analysis of Polling During the Implementation Period, 2010–2016
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问题措辞是否预示着对平价医疗法案的支持？2010-2016 年实施期间的民意调查分析
DOI：
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发表时间：
2018
影响因子：
3.9
通讯作者：
Jonathon P. Schuldt
中科院分区：
文献类型：
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作者：
K. Holl;J. Niederdeppe;Jonathon P. Schuldt
摘要《患者保护和平价医疗法案》(ACA)在美国仍然是激烈的政治辩论的主题。根据问题框架理论，结合对调查回应中措辞影响的研究，我们测试了ACA调查措辞上的共同差异与公众对该法律的明显支持之间的关系。我们报告了从2010年3月23日(奥巴马总统签署该法案使之成为法律)到2016年11月8日(选举日)这六年多时间里进行的N=376项美国全国民意调查的内容分析，并使用普通最小二乘(OLS)回归模型预测公众对该法律的支持率作为问题措辞变化的函数。我们对问题进行编码，以衡量对法律的总体情绪，以确定问题标签(例如，奥巴马医改、平价医疗法案)、它们是否提到特定的政治实体(例如，奥巴马总统、国会)或公众部分(例如，您、您的家人)、各种意见指标(例如，支持、支持)以及不同的回应选项(例如，废除、扩大)，我们使用这些问题来模拟总的支持水平。调查结果揭示了问题措辞上的几个关键差异-例如，对医保法的泛指使用频率远远高于奥巴马医改或平价医疗法案-其中一些可靠地预测了公众支持的总水平。讨论考虑了对这些模式的可能解释，并重申了在解释关于政治上有争议的卫生政策问题的调查数据时注意调查问卷设计特征的价值。
ABSTRACT The Patient Protection and Affordable Care Act (ACA) continues to be the subject of fierce political debate in the United States. Drawing on issue framing theory, together with research on wording effects in survey responding, we tested how common differences in the wording of ACA surveys relate to apparent public support for the law. We report on a content analysis of N = 376 U.S. national opinion surveys fielded during a more than six-year period, beginning 23 March 2010 (when President Obama signed the bill into law) and ending 8 November 2016 (Election Day), and use ordinary least squares (OLS) regression models to predict public support for the law as a function of variation in question wording. We coded questions gauging general sentiment toward the law for differences in issue labeling (e.g., Obamacare, Affordable Care Act), whether or not they referenced particular political entities (e.g., President Obama, Congress) or segments of the public (e.g., You, Your Family), various opinion metrics (e.g., Support, Favor), and different response options (e.g., Repeal, Expand) which we used to model aggregate levels of support. The results revealed several key differences in question wording—for example, generic references to the Healthcare Law were employed much more frequently than Obamacare or Affordable Care Act—a number of which reliably predicted aggregate levels of public support. The discussion considers possible explanations for these patterns and reiterates the value of attending to questionnaire design features when interpreting survey data about politically contentious health policy issues.