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Good Enough for Government WorkThe Public Reputation Crisis in America (And What We Can Do to Fix It)$
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Amy E. Lerman

Print publication date: 2019

Print ISBN-13: 9780226630175

Published to Chicago Scholarship Online: January 2020

DOI: 10.7208/chicago/9780226630342.001.0001

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When Citizens Opt In, Attitudes Can Change

When Citizens Opt In, Attitudes Can Change

(p.149) Eight When Citizens Opt In, Attitudes Can Change
Good Enough for Government Work

Amy E. Lerman

University of Chicago Press

This chapter shows that positive personal experiences with public health insurance can quickly and substantially improve people’s attitudes toward major public health programs like Medicare and the ACA. Importantly, these effects are actually strongest among Republicans and are not confined only to those with low or moderate levels of political information. Instead, results are strongest among those for whom health benefits are most salient (i.e., those in ill health) and among those whose insurance provides sufficient access to care (i.e., those who report that they have not put off care due to cost). These results suggest that individual attitudes toward the role of government can be changed, even among those who might be resistant to explicitly political messaging from elites. Specifically, when individuals personally receive what they consider to be valuable and well-administered public benefits, their attitudes toward public programs improve. If instead individuals choose to opt out of public programs and benefits, this precludes the possibility that people directly experience, and thereby learn from, effective government programs.

Keywords:   Affordable Care Act, Medicare, policy feedback, public opinion, political information

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