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Policy Uptake as Political Behavior: Evidence from the Affordable Care Act



Partisanship is a primary predictor of attitudes toward public policy. However, we do not yet know whether party similarly plays a role in shaping public policy behavior, such as whether to apply for government benefits or take advantage of public services. While existing research has identified numerous factors that increase policy uptake, the role of politics has been almost entirely overlooked. In this paper, we examine the case of the Affordable Care Act to assess whether policy uptake is not only about information and incentives; but also about politics. Using longitudinal data, we find that Republicans have been less likely than Democrats to enroll in an insurance plan through state or federal exchanges, all else equal. Employing a large-scale field experiment, we then show that de-emphasizing the role of government (and highlighting the market's role) can close this partisan gap.


Corresponding author

Amy E. Lerman, University of California, Berkeley, 2607 Hearst Ave, Berkeley, CA 94720 (
Meredith L. Sadin, University of California, Berkeley, 2607 Hearst Ave, Berkeley, CA 94720 (
Samuel Trachtman, University of California, Berkeley, 210 Barrows Hall, Berkeley, CA 94720 (


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The authors gratefully acknowledge the financial support of the Russell Sage Foundation; the Robert Wood Johnson Foundation Scholars in Health Policy Research Program; Professor Jack Citrin and the Institute of Governmental Studies at UC Berkeley; and the National Science Foundation. We are also indebted to Enroll America and the Kaiser Family Foundation for partnering with us in this research. Thanks also to Ed Coleman, John Ellwood, Ann Keller, Gabe Lenz, Neil O'Brian, and Robert Van Houweling, as well as the anonymous reviewers and editors of the APSR, for their helpful comments on early drafts of this work.



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Policy Uptake as Political Behavior: Evidence from the Affordable Care Act



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