The Affordable Care Act was a landmark political achievement in reforming the American health insurance system but has been subject to considerable political pressure. Administrative actions, such as eliminating federal advertising, have served as a replacement for failed legislative repeal efforts. We use a county-level fixed-effects model with data for thirty-four states for the 2015 to 2018 open enrollment periods to measure dose-response relationships between health insurance and health-care-related political advertising and Marketplace enrollment. State-sponsored advertising is related to greater Marketplace enrollment, but we find no association between federal advertising and enrollment. We are, however, unable to account for the endogeneity of advertising decisions across media markets and potential federal coordination with other sponsor types. These results have implications for understanding public roles within privatized policy implementation.
Bibliographical noteFunding Information:
© 2020 Russell Sage Foundation. Shafer, Paul R., David M. Anderson, Seciah M. Aquino, Laura M. Baum, Erika Franklin Fowler, and Sarah E. Gollust. 2020. “Competing Public and Private Television Advertising Campaigns and Marketplace Enrollment for 2015 to 2018.” RSF: The Russell Sage Foundation Journal of the Social Sciences 6(2): 85–112. DOI: 10.7758/RSF.2020.6.2.04. The authors acknowledge Wesleyan University and the Robert Wood Johnson Foundation for support to establish the advertising data infrastructure used in this study (State Health Access Reform Evaluation, 72179). This work has also been supported in part by the Russell Sage Foundation (1808-08181). Any opinions expressed are those of the authors alone and should not be construed as representing the opinions of the Robert Wood Johnson Foundation or Russell Sage Foundation. Direct correspondence to: Paul R. Shafer at email@example.com, 715 Albany St., Boston, MA 02118; David M. Anderson at firstname.lastname@example.org, 100 Fuqua Dr., Box 90120, Durham, NC 27708; Seciah M. Aquino at email@example.com, 1225 8th St., #375, Sacramento, CA 95814; Laura M. Baum at firstname.lastname@example.org, 45 Wyllys Ave., Middletown, CT 06459; Erika Franklin Fowler at email@example.com, 45 Wyllys Ave., Middletown, CT 06459; and Sarah E. Gollust at firstname.lastname@example.org, 420 Delaware St. SE, MMC 729 Mayo, Minneapolis, MN 55455. Open Access Policy: RSF: The Russell Sage Foundation Journal of the Social Sciences is an open access journal. This article is published under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
© 2020 Russell Sage Foundation.
- Affordable care act
- Health insurance