e Eastern Illinois University Political Science Review
Volume 3
Issue 2 Spring 2014
Article 4
January 2014
An Analysis of Media Use and Public Opinion
Toward the Aordable Care Act
Mahew Cain
Eastern Illinois University
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Recommended Citation
Cain, Ma9hew (2014) "An Analysis of Media Use and Public Opinion Toward the A7ordable Care Act," e Eastern Illinois University
Political Science Review: Vol. 3 : Iss. 2 , Article 4.
Available at: h9p://thekeep.eiu.edu/eiupsr/vol3/iss2/4
Media Use and Public Attitudes
1
An Analysis of Media Use and
Public Opinion toward the Affordable Care Act
Matthew Cain
Political Science Capstone
PLS 4600
Dr. Richard Wandling
Eastern Illinois University
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Table of Contents
Introduction 3
Literature Review 4
Methodology 8
Hypotheses 9
Analysis 10
Conclusion 20
References 21
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Introduction
In 2008, President Obama and Congress decided to tackle one of the most polarizing
policy challenges in American politics, addressing issues in our healthcare system. After months
of debate and gridlock, Congress passed the Patient Protection and Affordable Care Act.
However, the debate over healthcare reform exacerbated party partisanship and helped give rise
to massive polarization and fractionalization of the American public that now dominates the
American political system. Many factors contributed to this polarization, among them how
Americans viewed coverage of the healthcare debate. As the media have become more polarized
and more bent on providing a “balanced” approach to political stories by allowing all sides an
opportunity to share their opinions, it seems obvious that Americans who have partisan leanings
would gravitate to more partisan stations, and those who had less partisanship might take the
attitudes of those they watch. However, did Americans view news coverage of health reform by
partisanship? How did age and education factor into public opinion of the ACA? Did media use
factor into voters' perception of the Affordable Care Act? It is such questions that I will look
into.
The U.S. Healthcare System
Our healthcare system is broken! This phrase has been said numerous times by political
leaders, news media reporters and journalists, pundits, and healthcare experts. But, what exactly
does that mean? One problem is our high-uninsured rate. According to the Census Bureau
(2012), between 1987 and 2012 the uninsured rate in America crept steadily up, reaching a total
of 50 million uninsured Americans (16 percent of the population) in 2010. As of 2012, the
uninsured rate has dropped to 48 million Americans (15.4 percent of the population) (Census
Bureau, 2012). Those without insurance have to forgo proper medical treatments, regular doctor
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visits, and live-saving procedures primarily due to their lack of ability to afford such necessities.
As reported by the Washington Post (2009), the cost of these Americans being uninsured is
pushed on to the insured through a “hidden tax” amounting to 37 percent of their premium costs.
Healthcare experts and politicians alike agree something must be done to lower the uninsured
rate. A second, but just as important, problem is the high cost of our health system. In 2013, the
cost of employer-sponsored family health insurance was $16,351 and $5,884 for single coverage
(KFF, 2013). Compared to other countries, the U.S. spends nearly 17 percent of its GDP on
healthcare as of 2011, but utilized far less health resources like doctor’s visits compared to other
nations (OECD, 2013). So, drawn from these statistics, the political question is how to fix it.
Much of the debate has focused on how much federal involvement in necessary to fix a troubled
system. Recent debates and legislation aimed at fixing our healthcare system, which includes the
passage of the ACA, have spurred such questions on federal involvement. How these questions
of federal involvement reach the public sphere is through the media. In the next section, I will
look into the scholarly literature to see the theories produced by scholars into how the public
chooses and reacts to the various types of media.
Literature Review
The Patient Protection and Affordable Care Act of 2010 was historic for many reasons,
not only for what it seemingly accomplished, but also for the way it intensified an already
polarized nation. It was also notable for the way the media portrayed the debate for and against
health reform. Not only did many news stations take sides in the debate, but they also helped
frame the way the public views the Act and its subsequent implementation. Much of the previous
research on the media’s political effects is useful in understanding how the mass media affected
the way the public viewed the Affordable Care Act. The existing literature provides a foundation
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for my research on how the media affected the political attitudes of the public on the Affordable
Care Act by providing insight on media effects on the general public, selective exposure, and the
hostile news effect.
Media Effects on Political Behavior and Attitudes
Much of the historic literature looks at the way media affects political behaviors and
attitudes among the general public, especially focusing on targeted segments of the general
public. St. George and Robinson-Weber (1983) looked at how the media affects the political
attitudes and behaviors of African Americans compared to American Whites. Adding in
hypotheses to measure the amount of media exposure, the amount of motivation in media
exposure, and a comparison of African Americans and American Whites with regard to the
relative importance of the media on their political attitudes and behavior, their evidence suggests
that increased political information and the amount of exposure to print news are predictive of
political participation among whites, whereas blacks’ political participation increases with
exposure to television and a desire to watch television for political content (St. George and
Robinson-Weber, 1983). This research validates a study done 17 years earlier. Matthews and
Prothro (1966) looked at the effects of media exposure on southern African Americans, finding
that media exposure favorably affects political participation, interest, information, sense of civic
competence (efficacy), and attitudes toward changes. More recently, Bartels (1993) analyzed the
effects on political attitudes from the media’s framing of presidential campaigns. Bartels (1993)
found that the common assumption that media exposure has a minimal effect in political
campaigns is problematic because of a flawed methodology, whereas his study finds that there is
an effect that wears off over time. Bartels (1993) would also find the effect to be more powerful
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and distinctive in long-term opinion change, almost three-times more distinctive than previously
thought.
Selective Exposure
News media today is characterized by an abundance of choice. It is increasingly easy for
Americans to choose news sources slanted toward their own political views rather than sources
providing more diverse perspectives. This choosing of news sources that are slanted toward to
one’s own political opinion is known as selective exposure. Dilliplane (2011) used panel data
collected during the 2008 presidential campaign to investigate the whether exposure to news
slanted toward one’s partisan views increases political participation, while exposure to news with
the opposite partisan slant depresses participation. The author finds while that exposure to
partisan news does not alter turn out, the partisan leaning of the news sources citizens choose to
watch affects both when voters decide to participate and their levels of participation over time
(Dilliplane, 2011). Stroud (2007) investigated whether different media types (newspapers,
political talk radio, cable news, and internet) are more likely to inspire selective exposure. He
found that people’s political beliefs are related to their media exposure – a pattern that persists
across media types, and that people’s political beliefs motivate their media use patterns (Stroud,
2007). In a sense, one’s political predispositions will dictate what one will watch politically. On
a subject related to selective exposure, Morris and Forgette (2007) examined “news-grazers” –
individuals who watch television news with remote control in hand and switch to another
channel when an uninteresting topic comes up – and their place in American politics. They used
data from the Pew Research Center to analyze whether or not news-grazers differ significantly
from non-grazers in newsgathering habits, political knowledge, and behavior (Morris and
Forgette, 2007). Not only did they find that news-grazers differ significantly from non-grazers in
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news-gathering habits, political knowledge, and behavior, but also the effects remain significant
even when controlling for other factors associated with news-grazing frequency, such as age and
gender (Morris and Forgette, 2007). Their findings show that news-grazers avoid hard political
news, are less apt than non-grazers to follow news about Washington, international affairs, or
local government, and less likely to enjoy news with political debate or in-depth interviews
(Morris and Forgette, 2007). Possible consequences of these tendencies are that news-grazers are
less knowledgeable about the political world and less likely to participate in it (Morris and
Forgette, 2007).
Hostile News Effect
The hostile media effect predicts that audiences will perceive neutral messages to be
biased against their own position (K. Coe et al., 2008). Partisans that perceive relatively neutral
content as biased against their own position are thought of as the absolute hostile media
phenomenon (K. Coe et al., 2008). It is absolute in the sense that it assumes neutrality as a
starting point, and perceptions move from that position of neutrality. The relative hostile media
phenomenon can arise when an audience is exposed to genuinely biased content (K. Coe et al.,
2008). K. Coe et al. (2008) looked at this hostile media effect. They found partisanship
influences viewers’ perceptions of bias in cable news programs and content as well as that cable
news viewers are more likely to perceive bias in programs and content that do not align with
their own partisan perspective (K. Coe et al., 2008). In particular, they suggest that political
partisanship plays a significant role in exposure to CNN, Fox News, The O’Reilly Factor, and
The Daily Show. Liberals were more likely to report viewing The Daily Show and less likely to
report viewing the Fox content. Feldman (2011) also looked into the hostile media effect,
especially that of relative hostile media. He found that TV audiences perceive more story and
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host bias in opinionated news than in non-opinionated news, and these perceptions—particularly
perceptions of the host—vary as a function of partisan agreement with the news content
(Feldman, 2011). Specifically, he found that issue partisans appear to have a “bias against bias”
where they perceive less bias in opinionated news with which they agree with than non-partisans
and especially partisans on the other side of the issue (Feldman, 2011).
While scholars have contributed to our understanding of how the public views various
media coverage, very little to no research has specifically focused on the recent health reform
law and how the public viewed coverage of the debate. The Affordable Care Act was an epic
debate fought during President Obama’s first term. While many are now seeing the value of
understanding the Affordable Care Act, much of the research has focused on the politics of the
law. How did the public view Obamacare through the media? It is this question that I will
explore in this paper.
Methodology
To assess how Americans viewed media coverage of the Affordable Care Act and aspects
of public opinion toward the Act, I will begin by analyzing news coverage on health reform from
2008 to 2010 from various media stations – TV, radio, newspaper, and magazine coverage. To
do this, I will use the Pew Research Center Project for Excellence in Journalism’s News
Coverage Index Data Set from 2008 to 2010. These data sets include tens of thousands of stories,
ranging from newspaper stories, online stories, stories from network television, stories on cable
news, and stories from radio programs. My analysis will consist of finding trends within the
coverage like how much one station carried health reform as a topic. Also of interest is how that
station – whether digital, TV, or newspaper – is perceived by the American people and who
views the stations. Once I have analyzed the trends in health coverage, how Americans viewed it,
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and who viewed the particular content, I will analyze public opinion on healthcare by studying
the Kaiser Family Foundation (KFF) health opinion tracking polls from late 2009 to late 2010.
The KFF health tracking polls help to chart the progression of healthcare opinion in the U.S.
during the healthcare debate. Once trends in public opinion have been found, I will then use the
American National Election Study data set, which provides a myriad of information on political
attitudes over time as well as media exposure, cognitive style, values and predispositions, to
predict approval of the 2010 Affordable Care Act using TV viewership as the independent
variables. To predict such approval, I will employ a binary logistic regression analysis. The
dependent variable (measured as favoring or opposing the 2010 health law) and independent
variables (measured by asking respondent whether or not they regularly view a certain TV show)
in my analysis have been coded to be dichotomous, thus allowing for a logistic regression
analysis. Also, my regression analysis will include three control variables, all of which are coded
to be dichotomous – gender (male or female), education (post-high school education or not), and
party id (Democrat or other).
Hypotheses
For the regression analysis, hypotheses were created to correspond to each of the
independent variables in the analysis after controlling for three demographic factors – party id,
education, and gender – that could play a role in one’s attitude toward the Affordable Care Act.
H
1
: Americans who watch TV news shows that are characterized as politically
conservative will be less likely to favor the Affordable Care Act compared to Americans
who watch TV news shows that are politically liberal or moderate.
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H
2
: Americans who watch TV news shows that are characterized as politically liberal will
be more likely to favor the Affordable Care Act compared to Americans who watch TV
news shows that are politically conservative.
H
3
: Females will be more likely to favor the Affordable Care Act compared to Males.
H
4
: Americans who have some post-High School education or more will be more likely
to favor the Affordable Care Act compared to Americans who have only a High School
education or less.
H
5
: Americans who identify as Democrats will be more likely to favor the Affordable
Care Act compared to Americans who identify as other political party members.
For the regression analysis, the TV shows that were characterized as liberal or leaning
liberal included the Chris Matthew Show and the Daily Show with Jon Stewart. The TV shows
that were characterized as conservative or leaning conservative included: The Five, Fox Report,
Hannity, Huckabee, the O’Reilly Factor, Greta Van Susteren, and the Special Report with Bret
Baier. Because the ANES decides what TV shows to include in their survey, conservative shows
outweighed liberal shows in number. Therefore in my analysis, conservative shows will
outnumber liberal shows. I will include TV shows that are characterized as moderate or
independent in the analysis primarily to add variability to the types of TV shows being studied. It
is expected, however, that moderate TV shows will produce a null effect on opinion toward the
Affordable Care Act as conflicting viewpoints will not draw the watcher toward one side or the
other.
Analysis
President Obama began to debate healthcare reform when he announced a joint session of
Congress to tackle health reform. It was after this event that media coverage of the debate began.
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From February 2009 to June 2009, there was an increase of news coverage of health reform from
2.7 percent in February to 6.7 percent at the end of June, with a peak percentage of 7.4 in April.
In the early months of the debate, the same upward trend is seen in health coverage according to
media sector. All media sectors show a marked increase in health coverage over a two-year
period. Overall, from January 1, 2009 to June 30, 2009, the healthcare debate covered 37.5
percent of big news stories. Over the next year – from June 2009 to March 2010 when the law
was signed – coverage of the law went from 14.2 percent in July 2009 to a high of 27.1 percent
when the law was signed in March 2010. Healthcare reform was also the number one big story
for media overall, covering 13.9 percent of all stories. Of all the media platforms that covered
health reform, talk shows had the most coverage with 31 percent of all health reform-related
stories. Also of interest relating to talk shows, liberal talk shows covered more health reform
topics with 44 percent of all talk show coverage compared to conservative talk show coverage at
25.6 percent. This trend also continues with cable news channels. Of the three big news channels
– FOX, MSNBC, and CNN – MSNBC covered the most health reform topics at 32.3 percent of
total coverage, followed by FOX at 19.9 percent and CNN at 13.1 percent.
Figure 1
0"
5"
10"
15"
20"
25"
30"
Feb*09"
Mar*09"
Apr*09"
May*09"
Jun*09"
Jul*09"
Aug*09"
Sep*09"
Oct*09"
Nov*09"
Dec*09"
Jan*10"
Feb*10"
Mar*10"
Percentage)of)Total)News)
Percentage"of"Newshole"
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News Viewership, Demographics, and Political Opinions
Cable news programs continue to play a significant role in peoples’ news habits with 39
percent said they regularly get news from a cable channel. However, the proportions saying they
regularly watch CNN, MSNBC and CNBC slipped substantially from 2008 during the
presidential election. Only Fox News maintained its audience size primarily due to the increasing
number of Republicans who regularly get news from the station. Four-in-ten Republicans (40
percent) said they regularly watched Fox News in 2010, up from 36 percent in 2008. Just 12
percent of Republicans regularly watch CNN, and just 6 percent regularly watch MSNBC.
Overall, the total number of individuals who watch Fox News from 2008 to 2010 remained at 23
percent, while CNN’s total share dropped from 24 to 18 percent and MSNBC dropped from 15
percent to 11 percent. In terms of specific programs, Sean Hannity, Glenn Beck and Bill
O’Reilly succeeded in attracting conservative and attentive audiences as did radio host Rush
Limbaugh during the 2008 to 2010 period. Most of those who regularly watched O’Reilly (63
percent) and Hannity (65 percent) were 50 or older (44 percent of the public is 50 or older). By
contrast, the Daily Show and Colbert Report have the youngest audiences of any outlet, with 80
percent (Colbert Report) and 74 percent (Daily Show) being younger than 50 (55 percent of
public is 18 to 49).
Figure 2
0"
10"
20"
30"
2008"
2010"
Viewership)by)
Percentage)
Data from the Pew Research Center Project for Excellence in Journalism’s News Coverage Index Data Set
Cable)News)Viewership)by)Year)
FOX"
CNN"
MSNBC"
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Table 1
Cable News Shows Viewership by Age
O’Reilly
Hannity
Daily Show
Colbert Report
50 & Older
63%
65%
26%
20%
Younger Than 50
37%
35%
74%
80%
Data from the Pew Research Center Project for Excellence in Journalism’s News Coverage Index Data Set
Newsgrazing Behavior and the Hostile News Effect
Consistent with the news grazing literature, the analysis shows that in 2008, 51 percent of
Americans grazed for news, while in 2010, roughly 57 percent grazed for news. The percentage
saying they are more likely to get their news at regular times dropped from 50 percent in 2006 to
45 percent in 2008 and then to 38 percent in 2010. Also consistent with the news grazing
literature, young people continue to view news regularly as opposed to older people who view
news graze. That remained the case in 2010 as those of the 50 to 64 age group said they get news
from time to time (49 percent). In 2008, a majority (55 percent) of this age group said they got
news at regular times. Those 65 and older are still most likely to get their news at regular times
(57 percent), but that is down from 64 percent in 2008.
Education is also closely tied to news grazing and viewership during the 2008 to 2010
period. People with no more than a high school education were more likely in 2010 to be a news
grazer. Among that group, the percentage that says they get news graze increased from 49
percent in 2008 to 58 percent in 2010, while the number saying they get their news at regular
times dropped from 47 percent to 36 percent. Majorities among some college education (59
percent) and college graduate education (54 percent) said they news grazed in 2010, up from 56
percent and 51 percent respectively in 2008.
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Figure 3
Just as age is associated with viewership, ideology continues to be closely associated with
people’s choice of certain news sources. Eight-in-ten Americans (80 percent) who regularly
listen to Rush Limbaugh or watch Sean Hannity are conservative – roughly twice the national
average of 36 percent. And at the other end of the spectrum, the New York Times, Keith
Olbermann, the Daily Show, the Colbert Report and Rachel Maddow had regular audiences that
include nearly twice the proportion of liberals than in the public. Americans are also drawn to
different sources for different reasons. Of the major news sources, substantial proportions – CNN
(64 percent), FOX (44 percent), MSNBC (43 percent), and evening news shows (59 percent) –
view the network for the latest headlines, while substantial proportions of night-time programs –
Hardball (42 percent), Maddow (33 percent, Hannity (39 percent), and the O’Reilly Factor (44
percent) – watch the show for opinions and views.
As with the news-grazing literature, the analysis also shows Americans’ viewing of
media from 2008 to 2010 is also consistent with the hostile news effect. Most Americans said
they trust certain news sources more than others. In 2010, 57 percent expressed this view, up
from 53 percent in 2008. About four-in-ten (39 percent) said they see all the news media as the
same. That is down from 43 percent in 2008. About three-quarters of conservative Republicans
(76 percent) and 69 percent of liberal Democrats said they trust few news sources. As with
0"
20"
40"
60"
Overall"Newsgrazers"
Overall"Non*
Newsgrazer"
Ages"50*64"
Newgrazers"
Ages"65+"
Newgrazers"
Percentage)
Data from the Pew Research Center Project for Excellence in Journalism’s News Coverage Index Data Set
Newgrazers)by)Year)
2006"
2008"
2010"
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0"
10"
20"
30"
40"
50"
60"
70"
Education"
Trust)by)Education)
High"School"
Degree"or"Less"
Some"College"
College"Degree"
or"More"
51"
52"
53"
54"
55"
56"
57"
58"
Trust"Certain"News"
Sources"To"Others"
Trust)by)Year)
2008"
2010"
trustworthiness, about eight-in-ten Americans (82 percent) said they see at least some bias in
news coverage and 52 percent said they see a lot. Fewer of those with a high school degree or
less said they see at least some bias than those with some college experience or a college degree
or more education. About four-in-ten (39 percent) of those with a high school degree or less said
they see a lot of bias, compared with 58 percent of those with some college experience and 64
percent of those with a college degree or more education.
Public Opinion toward the ACA
At the beginning of healthcare reform, Americans overall viewed the need to address the
concerns of our health system with grave earnest. In February of 2009, as the debate was
beginning, roughly 62% of Americans believed that it was more important than ever to take on
health care reform now. Over the course of the summer, that trend would fluctuate from 62% to
Data from the Pew Research Center Project for Excellence in Journalism’s News Coverage Index Data Set
64"
66"
68"
70"
72"
74"
76"
78"
Partisanship"
Trust)by)Party)
Democrat"
Republican"
Figure 4
Figure 5
Figure 6
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57% by September of 2009. The trend would continue to decline into next year going to 54% by
the end of January 2010. By July 2010, opinion ends with a final percentage of 50. A closer look
at public opinion after the signing of the bill shows significant results when looking at variables
such as age and partisanship. Views of the law continue to be based on partisanship, with
Democrats much more likely to have favorable views (73% favorability in July 2010) and to
perceive positive impacts, Republicans more likely to have unfavorable views (21% favorability
in July 2010) and to perceive negative impacts, and Independents somewhere in the middle (48%
favorability in July 2010). Age also tends to be a predictive factor in favorability towards the
law. For those individuals between ages of 18-64, 53% had a favorable view of the law,
compared to 33 who had an unfavorable view. Those of the ages 65+ have a more negative view
with 38% favorable and 46% unfavorable. In all, general opinion of the law when studied shows
that 50% of the U.S. favored the ACA, while 35% opposed the law.
0"
20"
40"
60"
80"
100"
120"
Feb."2009"
Sept."2009"
Jan."2010"
Jul."2010"
Data from the Kaiser Family Foundation (KFF) health opinion tracking polls
Not"As"Important"
More"Important"
Figure 7
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Table 2
Opinion of ACA by Partisanship (July 2010)
All
Dem.
Ind.
Rep.
Net Favorable
50%
73%
48%
21%
Very Favorable
21
33
19
6
Somewhat Favorable
29
40
29
15
Net Unfavorable
35%
15%
37%
69%
Somewhat Unfavorable
10
8
11
16
Very Unfavorable
25
7
26
53
Don’t Know/Refused
14%
12%
15%
10%
Data from the Kaiser Family Foundation (KFF) health opinion tracking polls
Table 3
General Opinion of ACA by Age (July 2010)
All
Ages 65+
Ages 18-64
Favorable
50%
38%
53%
Unfavorable
35%
46%
33%
Don’t Know/Refused
14%
17%
14%
Data from the Kaiser Family Foundation (KFF) health opinion tracking polls
Regression Analysis
Table 4 presents the results from the binary logistic regression analysis in which approval
of the 2010 healthcare law was predicted using various independent variables. Consistent with
hypotheses four and five, Americans who had any post-high school education were more likely
to favor the Affordable Care Act than those who only had a high school education or less, and
Democrats had a higher favorability of the Affordable Care Act when compared to Americans
who identify with other political parties. For example, the odds ratio of 1.306 for high school
education indicates a 30.6 percent increase in the odds of holding a favorable view of the ACA.
Inconsistent with the third hypothesis, gender was not a reliable predictor of favorability of the
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ACA. Though it was hypothesized that women would be more receptive to the ACA, opinion
polling on how men and women feel about the ACA from 2010 does support the results (Pew
Research 2010). When looking at the first hypothesis, five out of the seven conservative TV
shows were significant in their predictability of favoring the ACA. Looking deeper into the TV
shows, it can be seen that the single-person talk shows (e.g. O’Reilly Factor) have a greater
predictability than the Five (a multi-person show) and Greta Van Susteren. Possible explanations
for the greater predictability among single-person talk shows is that there is no counterpoint to
the conservative hosts and that conservatives in general are more likely to watch these
opinionated news shows. Confirming the second hypothesis, the liberal TV shows proved to
have great predictability of approval of the ACA. For example, the Chris Matthews Show has a
nearly 300 percent increase in the odds of holding a favorable view of the ACA. Finally, when
looking at the moderate TV shows, we can see that four out of the eight TV shows had a positive
predictability in approval of the ACA. Most notably, Meet the Press had 46 percent increase in
the odds of holding a favorable view of the ACA. One explanation for Meet the Press’s positive
predictability could be that it re-airs on MSNBC later on its broadcasting day. Because MSNBC
is known for its liberal-leaning viewpoints, Americans who are more liberal politically might
watch Meet the Press and thus influence the show’s predictability. Overall, hypotheses one, two,
four, and five were confirmed.
Table 4. Odds Ratios of TV Show Viewing on Opinion of ACA
Predictors
Female
1.087
(.067)
Post-High School
1.306**
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(.069)
Democrat
5.223**
(.066)
60 Minutes
1.115
(.089)
ABC News Nightline
1.284*
(.098
ABC World News Tonight
1.249*
(.096)
Anderson Cooper
1.334*
(.116)
CBS Evening News
.987
(.089)
Chris Matthews Show
3.991**
(.182)
Daily Show with Jon Stewart
2.680**
(.154)
Face the Nation
.918
(.139)
The Five
1.050
(.296)
Fox Report
.703**
(.108)
Frontline
1.177
(.144)
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Media Use and Public Attitudes
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Hannity
.407**
(.272)
Huckabee
.538*
(.298)
Meet the Press
1.460**
(.130)
NBC Nightly News
1.090
(.085)
O’Reilly Factor
.414**
(.174)
Greta Van Susteren
.856
(.246)
Special Report with Bret Baier
.407**
(.276)
LR Chi
2
(df)
566.306*** (42)
Note: N = 5500. Values represent odd ratios for ease of interpretation. Standard errors are in Parentheses. Data
from American National Election Survey. * p < .05; ** p < .01; *** p < .001 (two-tailed tests).
Conclusion
According to my results, Americans did in fact view the news coverage of the Affordable
Care Act by partisanship. Also of interest is how age and education tend to guide those to
viewing certain coverage. Overall, the analysis shows that public opinion toward the ACA tends
to be associated with age and partisanship. It too must be noted that the Americans’ viewership
of the ACA also fits in with the literature on news grazing and the hostile news effect. While it
cannot be definitely said that age, education, or partisanship are what determined an American’s
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Media Use and Public Attitudes
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feelings regarding the ACA, the research showed that such variables are key to understanding
how opinions about healthcare are formed. Also, the regression analysis for media use and public
opinion were particularly interesting. Attention paid to TV shows that were conservative in
nature had a significant negative effect on favorability toward the ACA, while TV shows that
were liberal in nature had a significant positive effect on favorability toward the ACA.
Surprisingly, half of the moderate TV shows analyzed showed a positive effect on favorability
toward the ACA. While gender did not have a measurable effect on favorability, education and
political party played very significant roles in Americans’ favorability toward the ACA. While it
should be noted that many factors contribute to one’s understanding and liking of a particular
piece of legislation, the analysis presented in this paper shows that media use has a measurable
effect on the favorability of the ACA and thus should be counted as one of those contributing
factors.
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