Symbolic politics and self-interest in post-Affordable Care Act health Insurance coverage

Abstract

Social scientists have long shown that self-interest rarely has a large effect on citizens’ sociopolitical attitudes. Instead, Americans’ opinions about public policy are driven more by symbolic predispositions. Yet those opinions about policy may just be cheap talk. When Americans are faced with costly behaviors that pit their interests against their values, perhaps self-interest will play a larger role. Post-Affordable Care Act (ACA) health insurance coverage provides an important test for self-interest and symbolic politics. Faced with costly decisions to pay fines or purchase insurance, did Americans put symbolic politics over material self-interests? Using a monthly tracking poll, we first show that symbolic attitudes overwhelm self-interest in shaping public opinion about health policy. Marshaling data from over one million respondents from Gallup’s Tracking Poll, however, we show that both self-interest and symbolic predispositions are associated with decisions to purchase health insurance under the ACA.