Racial Prejudice and Public Opinion on American Health Care Reform

Belcher III, Lawrence R.

The American health care reform initiatives of 2010 provide a unique opportunity to study the relationship between race, politics and social policy. Not only does the Affordable Care Act promise to reduce dire discrepancies in health conditions between blacks and whites; it is also a major accomplishment of America’s first black President, and has been widely attributed as a presidential undertaking (“Obamacare”). Perhaps not coincidentally, “Obamacare” has been controversial, and it witnessed a much more profound resistance than similar proposals made by Presidents Nixon and Clinton. Observational and experimental studies have already suggested that racial prejudice may explain some of this phenomenon (Knowles et al 2009; Hetherington and Weiler 2009). Still, we do not know much about the specifics of this relationship, and no existing study has addressed the possibility that anti-Obama prejudice is confounded by a more generalized racial resentment, akin to the racially charged opinion associated with welfare policies such as food stamps and federal cash assistance. This paper uses a survey-embedded experiment to test the hypothesis that racial prejudice reduces support among whites for health care reform. Results indicate that white subjects, especially those who are politically independent, insured and wealthy, react negatively to health care legislation endorsed by a black politician. There is very little evidence that the race of the plan’s beneficiaries has an effect on whites’ reactions. In addition, whites express higher levels of specific concern, racial resentment and colorblindness when considering a plan endorsed by a black politician. In short, public opinion on health care reform is subject to the influence of multi-faceted and substantial racial prejudice, especially surrounding the race of the politician in charge.


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The Journal of Politics and Society

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Helvidius Group
Helvidius Group of Columbia University
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February 10, 2014