Obamacare Implementation and the 2016 Election
73 Pages Posted: 27 Nov 2017 Last revised: 20 May 2018
Date Written: May 19, 2018
We combine administrative records from the federal health insurance exchange with aggregate- and individual-level voting data to examine how health care reform affected the 2016 election. Overall, we show that personal experiences with the Affordable Care Act influenced voting decisions and conceivably altered the presidential election outcome in pivotal states, suggesting that Republican efforts to undermine the law's implementation paid tangible political dividends. We also find that voters purchasing coverage through the exchange responded to premium price hikes publicized shortly before the election -- despite most receiving a tax credit that largely shielded them from the increases. We hypothesize that the exchange website's design and information in renewal letters sent by insurers, both of which reduced the salience of federal subsidies, made consumers needlessly sensitive to the "sticker prices'" of health insurance. Survey responses collected before the premiums became public provide additional evidence that these effects are indeed causal.
Keywords: 2016 Presidential Election, Obamacare, Affordable Care Act, Policy Feedback, Retrospective Voting, Health Policy
JEL Classification: I13, I18, H50, H51, H70, H77
Suggested Citation: Suggested Citation