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Week 13: Health Care Reform

by: Jennifer Kim

Week 13: Health Care Reform GVPT289O

Marketplace > GVPT289O > Week 13 Health Care Reform
Jennifer Kim

Racial and Ethnic Politics in the Obama Era
Dr. Antoine Banks

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Hi! Here are my notes for Week 13 of GVPT289O. This includes the reading notes for the week as well as lecture notes. Happy studying!
Racial and Ethnic Politics in the Obama Era
Dr. Antoine Banks
Class Notes
GVPT289O Antoine Banks Obama Notes racial ethnic politics government gvpt umd umcp college park government and politics racial ethnic
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This 10 page Class Notes was uploaded by Jennifer Kim on Saturday December 12, 2015. The Class Notes belongs to GVPT289O at a university taught by Dr. Antoine Banks in Fall 2015. Since its upload, it has received 43 views.


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Date Created: 12/12/15
GVPT2890 111715 Page 1 of 2 Lecture 20 Healthcare Reform NOTE No class on Thursday 1119 Quiz in discussion on Friday Overview Problems with US Healthcare system rising cost access 2008 Health Care Reform Debate Affordable Care Act Health Care System In 2008 we had about 38 million Americans who did not have health insurance The uninsured has risen over the past 30 years Middle class wage earners have gone form 5 uninsured to 124 uninsured The lowest income wage earners have gone from 18 to 374 uninsured We also have 16 million more Americans who are underinsured The US spends twice as much per person on health coverage than other developed democracies These countries provide their entire population with health coverage US Health Care System In the 19th century most advanced nations created some system of universal health insurance coverage Either heavily regulated or governmentcontrolled In the 19th century the US focused more on innovation in the health care industry This led to the country focusing more on profitable health care than providing coverage to all Americans It contributed to unequal health coverage in the US In 1965 Medicare and Medicaid are established President Johnson signs HR 6675 Public Law 8997 to establish Medicare for the elderly and Medicaid for the poor particularly non working mothers and their children Medicare for the elderly Medicaid for lowincome individuals With a sluggish economy from 20002007 and health carer premiums on the rise many Americans were concerned with the cost of health care 2008 Health Care Debate Hillary Clinton made health care reform an important issue of her campaign Obama didn t have a strong proposal for fixing Americans health care system Once Obama won the Democratic nomination he adopted Hillary Clinton s health care proposals He made health care a central issue in his campaign Affordable Care Act Majority say they don t understand how ACA will impact them including 23 of uninsured and lowincome less than 40K Beneficiaries of the Affordable Care Act Seniors Under Medicare the ACA closes prescription drug doughnut holes It also expands primary care to seniors via preventive care It provides more funding to family medicine doctors It also provides more assistance to longterm care Young adults Parents can keep their child on their family insurance until age 26 Also young adults qualify for Medicaid if their annual income is under 14444 GVPT2890 111715 Page 2 of 2 Middle Americans People without insurance can participate in insurance exchanges They will have the benefit of choosing their insurance The competition in these exchanges should lower the cost for the rate of insurance It also requires everyone to purchase insurance and if not they will face a penalty or fine This individual mandate is to keep insurance cost low Most vulnerable Americans are the largest beneficiaries under the ACA lt expands Medicaid to American adults who don t have children This should cover 16 million more Americans Can we afford health care reform The cost of the ACA is 1 trillion dollars Half of the bill is paid by taxing the most wealthiest individuals and health care companies Reducing the cost in health care should trim the rest of the cost By lowering the cost hospitals pharmaceutical and insurance companies could charge should reduce the cost of the health care Congressional Budget Office says the ACA should reduce the federal government s deficit by about 140 billion dollars over the first 10 years After 5 years of passage of ACA people seem to be more knowledgeable about ACA Most are aware of key provisions but gaps in knowledge remain Three year later the public is still divided by party on the ACA Republicans have consistently been in serious opposition since 2010 GVPT2890 T T 112415 Page 1 of 2 Lecture 20 Obamacare Biggest effect of race was among racial liberals he Spillover of Radicalization into Health Care Two sides of racialization We know that race had a substantial effect on the 2008 election more so than any other time on record The symbolic nature of potentially having a black president made race more chronically accessible in the minds of many Americans in comparison to previous presidential campaigns As a consequence support for Obama became more polarized by racial attitudes That is his candidacy pushed racial conservatives to be more in opposition to him and racial liberals to be more supportive of him What about policies associated with Obama Does race play a role in this domain Spillover of racialization Race not only shaped evaluations of Obama but also influenced policies strongly associated with him The process works via what is known as transfer of affect racial predispositions were transferred from opinions about Obama to related political evaluations when there was a strong association between the two Banks thinks this argument is not that strong He does not think that race will have an effect on every policy he attaches himself to For example environmental policies like clean energy Can environmental policies be racial Banks thinks that race will be a factor only when there might be a possibility that racial minorities will benefit He argues that race would matter for people with oldfashioned bigotry that would oppose any policy Obama attaches himself to simply because he s blacks Ultimately it s debatable Michael TA argues that even though a person may not consciously observe a connection between a policy like clean energy and race because of their subconscious negative attitudes and views people will be against a policy if it s associated with Obama Racial resentment vs oldfashioned bigotry People who are racially resentful don t like blacks not because they re black but because they have negative racial views because of the supposed characteristics of the race lazy not smart etc Once Obama took office and aligned himself with health care reform opinions on health care became more polarized by racial attitudes Clinton vs Obama when they were championing health care reform Partisanship held constant Resentment coefficient Shows racial resentment had a much more negative effect when Obama was associated with health care reform Stereotype coefficient Effect is more negative for Obama Obama s attachment to health care has racialized people s opinion he Public s Anger and Health Care Theory of Anger and White Racial Attitudes People s anger tightly linked to race People on the left attribute racial problems to institutional bias People on the right attribute racial problems to the individual and their character Whites high in racial resentment blame blacks for America s racial problems Whites low in racial resentment hold racial bigotry and discrimination responsible for America s racial problem Anger should be strongly linked to whites racial attitudes Since anger and racial attitudes form a strong bond Banks expects that experiencing anger should make racial attitudes more accessible in whites minds GVPT2890 112415 Page 2 of 2 Experimental Manipulation Anger Condition When people look at pictures of people who are angry people tend to feel angry in response Reading someone else s facial cues can affect how you feel Anger was polarizing their racial attitudes much more than their ideological position but ideology still mattered Summary Obama racialized whites opinions toward health care Racial conservatives became more opposing of health care and racial liberals became more supportive of the policy Obama s association with the policy did not make raceneutral considerations eg ideology a stronger predictor of health care opinions Anger uniquely increases the impact of racial attitudes on health care opinions while having no effect on nonracial attitudes When anger is an important part of the policy debate outgroup biased will more likely be attached to the issue Reading Michael Tesler The Spillover of Racialization into Health Care How President Obama Polarized Public Opinion by Racial Attitudes and Race Study documents impact of race and racial attitudes on health care opinions before and after Barack Obama became the face of the policy PTeSident Obama s strong association with an issue like health care should polarize public opinion by racial attitudes and race Evidence suggests that Obama s legislative proposals have the potential to polarize issue opinions by racial attitudes and race Findings show that racial attitudes were both an important determinant of white Americans health care opinions in the fall of 2009 and that their in uence increased significantly after President Obama became the face of the policy Moreover results show that racial attitudes had a significantly greater impact on health care opinions when framed as part of President Obama s plan than they had when the exact same policies were attributed to President Clinton s 1993 health care initiative Obama also appears to be driving the policy preferences of blacks and whites farther apart Racialization racial attitudes are brought to bear on political preferences SPiHOVCr 101311239011 racial attitudes spill over into health care opinions Race targeted policies are thought to readily evoke racial predispositions because there is a natural associative link between policy substance and feelings toward the groups who benefit from them Prior research suggests that this racialization of issues with no manifest racial content results from mass communications that heighten the association either consciously or unconsciously When messages are framed in such a way to reinforce the relationship between a particular policy and a particular group it becomes far more likely that individuals will evaluate the policy on the basis of their evaluations of the group 2005 109 Those subtle race cues are especially effective in activating racial attitudes because they connect African Americans to political evaluations without audience members consciously knowing the message violates strong societal norms of racial equality Along with such established avenues source cues provided by the background characteristics of elite issue advocates may also foster connections between governmental policies and social groups In fact a series of findings indicates that prominent position takers races religions and genders can all activate group specific attitudes in mass opinion formation Experiments show that Americans willingness to embrace elite views depend in part on whether the positions are attributed to black or white sources Salient social characteristics of elite sources have the potential to activate considerations in the realms of race religion and gender then President Obama s legislative initiatives should be especially ripe for racialization Embodiment of race combined with the profound racial symbolism surrounding Obama s position as the first black president is often cited as the reason why racial attitudes had a significantly stronger impact on mass assessments of him in both the 2008 campaign and in the first year of his presidency than they had on evaluations of previous presidents and presidential candidates GiVeh the importance 0t ehtes background characteristics the salience of Obama s race in public perceptions of him should also spill over into public opinion about his visible policy positions More specifically source cues that connect racialized public figures to specific issues are eXpected to activate racial considerations in mass opinion much the way that code words and other subtle race cues have linked African Americans with public policies This hypothesis which I call the spillover of racialization therefore situates Obama s race and the public s race based reactions to him as the primary reason why public opinion about health care opinions racialized in the fall of 2009 Health care policies were significantly more racialized when attributed to President Obama than they were when these same proposals were framed as President Clinton s 1993 reform efforts Obama repeatedly rebutted claims that hostility toward his health care plan was rooted in racial animus He suggested instead that the media was merely pursuing this prejudiced opposition narrative because race continues to evoke such powerful emotions in American society Since the PTeSideht s association with health care racialized Americans issue positions one might even assume that mass political decision making in general would become increasingly polarized by racial attitudes and race during his presidency Evidence indicates that source cues provided by the background characteristics of elite issue advocates offer another avenue to activating race based considerations in political evaluations Newly established path to racialization might be even more effective in polarizing public opinion by racial predispositions than the well documented effects of subtle race coded communications in previous racial priming research COhChldihg from those TCSUItS that Obama s race was responsible for the increased effects of racial attitudes on white Americans health care opinions in 2009 is problematic however There is simply no way of knowing whether the growing polarization of public opinion by racial attitudes shown in Table 2 and Figure l was caused by the president s race or another factor like his party affiliation The Clinton and Obama eXperimental conditions help disentangle those two potential in uences Implicit racial appeals have to walk a very fine line to avoid violating strong societal norms of racial equality and even then they can lose their effectiveness if criticized for playing the race card Mendelberg 2001 2008 Moreover the priming effects from such subtle race appeals are thought to be short lived losing much of their impact when communications make new considerations salient Kinder and Sanders 1996 In contrast there is nothing necessarily untoward about communications that point out a racialized public figure s policy positions Source cue racialization should also be longer lasting than campaign appeals that prime race if the media persistently highlight the racialized source s position ie Obamacare Reading Antoine J Banks The Public s Anger White Racial Attitudes and Opinions Toward Health Care Reform Anger uniquely pushes racial conservatives to be more opposing of health care reform while it triggers more support among racial liberals On the other hand anger does not enhance the effect of race neutral principles on health care reform Because the public mostly associates blacks with welfare racial attitudes tend to dominate their Opinions Health care debate has produced similar appraisals and is viewed by opponents as another sign of government redistributing resources from hardworking Americans to underserving individuals Recent research suggests that public opinion over health care is more polarized along racial lines than non racial ideological lines When health care is framed as part of Obama s reform plan racial attitudes have a much stronger effect on health care opinions than race neutral principles Anger contributes to this racial polarization effect Banks contends that anger makes thoughts about race more accessible in many white Americans minds thereby enhancing the effect of their racial attitudes on health care policy opinions That is anger should push racial liberals to be more supportive of health care and racial conservatives to be more opposing of health policy adding to the recent racial polarization over health care reform He argues that this process occurs because anger is tightly woven into the fabric of whites racial predispositions so that in fact the two are fused together in memory Counter to what some scholars and pundits suppose anger over health care reform is not rallying race neutral principles such as a preference for small and efficient government or even race neutral ideological identities Instead he proposes that anger uniquely heightens the impact of racial attitudes on opinions toward health care reform while having no effect on race neutral principles Appraisal theory suggests that an emotional eXperience first requires people to appraise their environment in relation to their personal well being Primary appraisals inform us if the environment is congruent with our goals If so positive emotions result If circumstances are incongruent with our goals negative emotions occur Secondary appraisals then differentiate emotions further and identify options for coping and future eXpectations These appraisals include blameresponsibility certainty and control and they help to determine when environmental threats specifically produce anger fear guilt or sadness Anger is eXperienced when a person has been threatened and more importantly when an individual is certain about Who s responsible or blameworthy for the offense Moreover angry people perceive they have control over the likely outcome Contemporary debates on race usually revolve around whether government redistribution of rights and resources to blacks is unfair Symbolic Racism also known as racial resentment has been shown to result in racially conservative policy and candidate preferences TOdaY s subtle form of racism is defined as a blend of anti black affect and perceptions that blacks violate core American values Symbolic racism centers on the contentions that blacks do not try hard enough to overcome the difficulties they face and that they take what they have not earned According to appraisal theory of emotion this blame attribution is essential for anger If the contemporary racial debate is dominated by blame rhetoric I suspect that anger should be strongly linked to whites negative racial predispositions Work in psychology also suggests that anger is the emotional underpinning of whites negative racial attitudes In intergroup emotions theory Mackie et al find that people who appraise their in group as strong and powerful react with anger towards the out group not fear or disgust and are more inclined to take action against the group Racial liberals believe that racism and discrimination are mainly responsible for blacks disadvantages in society and not their work ethic For racial liberals racism historically and perhaps currently is to blame for why blacks have received less than they deserve While whites high in symbolic racism blame the moral character of blacks for America s racial problem whites low in symbolic racism blame the discrimination and racism blacks have endured over generations As a result blame attributions seem to be an important appraisal driving the beliefs of those low in symbolic racism Because of this I suspect that the beliefs of whites low in symbolic racism should also be strongly linked to feelings of anger Emotion is instrumental in learning and recall That is information learned in one emotional state is more easily recalled when subjects are returned to that same emotional state If anger is strongly linked to racial schemas in memory for many whites this emotion should make thoughts about race more accessible in their minds As a result subsequent policy decisions should be more strongly predicted by the predisposition Given that research has shown that people s opinions on health care reform are already racialized Banks suspects that anger should enhance the effect of racial attitudes on health care views above their effect when anger is absent For instance Banks and Valentino find that anger and not disgust or fear can in fact heighten the effect of negative racial predispositions on racial policy preferences Moreover Banks and Bell demonstrate that anger generated from an implicit racial appeal pushes racial conservatives to be more opposing of racial policies while it triggers more support among racial liberals Hypotheses The eXperience of anger even when generated by a non political or non racial stimulus will boost opposition to health care reform among whites high in symbolic racism Anger will increase support for health care reform among whites low in symbolic racism Anger and racial considerations are tightly linked in memory so anger will make thoughts about race more accessible in people s mind Race neutral attitudes should not be affected by anger Anger and race neutral principles are not strongly linked in memory anger should not boost the impact of this belief system on opinions about health care reform Racial attitudes and race neutral attitudes should not be affected by fear Fear is not strongly tied to either racial or non racial predispositionsso fear should not increase the effect of any of these attitudes on health care policy opinions Anger will boost the effect of racial attitudes on opinions about health care reform even when compared to enthusiasm Thoughts about race are more tied to anger than enthusiasm Findings Anger uniquely increases the impact of racial attitudes on health care opinions while having no effect on non racial attitudes That is the experience of anger further polarizes racial liberals and racial conservatives by as much as 15 points relative to the relaxed condition The anger condition does not boost the impact of race neutral principles like liberal conservative ideology or preferences for small and efficient government on health policy opinions The fear condition increases support for reform among political liberals The anger condition has a strong effect on racial attitudes and no effect on non racial attitudes in the case of health care reform To be clear it is not that non racial predispositions have no effect on health policy opinions rather that non racial ideological beliefs are not amplified by anger Anger and enthusiasm in uence white racial attitudes differently The anger condition relative to the enthusiasm condition increases opposition to health care among those high in symbolic racism and boosts support for health policy among those low in symbolic racism That is the anger condition further polarizes racial liberals and racial conservatives opinions on health care by about 44 percentage points Findings indicate that anger rather than enthusiasm makes racial liberals more supportive of health care reform Summary Of nding33 When anger is induced independent of political and racial content subjects high in symbolic racism are more likely to oppose health care reform This result suggests that racism can enter into politics even when political elites avoid using group cues e g race implicitly or explicitly Therefore opponents of policies perceived to benefit blacks can still activate race by inducing anger in a way that gives them plausible deniability The findings also show that anger increases support for health care among respondents low in symbolic racism Conversely anger has no effect on non racial attitudes These results are consistent with other scholars findings that health care has become more racially polarized since Obama s election On the other hand the impact of ideological self placement on heath care opinions has barely changed at all from 2007 to 2009


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