Obamacare or the ACA? Understanding Young Adults' Attitudes Toward the Affordable Care Act

Theoretical Background and research questions/hypothesis:  This study examines knowledge of and attitudes toward the Affordable Care Act (also known as the ACA, and colloquially as “Obamacare”) among young adults. The 60-year-old theory most relevant to this study is Rosenstock’s Health Belief Model (HBM) which posits that preventive health action stems from perceptions of severity of risk of a disease and perceived susceptibility to it. Studies of college students’ risk-taking behavior using the HBM show a lack of understanding of their own risks. Hypotheses addressed include: Young adults perceive themselves to be at low risk of illness or injury, which leads them to believe they do not need health insurance; Attitudes of young adults toward the ACA and its requirement to purchase health insurance are influenced by their political beliefs and attitudes toward social services. Research questions include: Where do young adults get information about the Act? Which sources are they most likely to trust? Does the name by which they know the new law affect their support? Do their parents’ political beliefs influence their attitudes toward the law?

Methods:  This 33-question online survey of 1369 students aged 18 to 30 was conducted at a large public university in the Southeastern United States from November 11^th, 2013 to November 21^st, 2013.

Results:  Perceptions of good health had statistically significant correlation with perceived need to see a doctor in the near future, and with confidence in ability to pay for care. Participants’ most-used source for information about the ACA was an online search engine; most trusted were Federal agencies such as the agency responsible for the Healthcare.gov website (the much-publicized failure of which occurred prior to this survey), followed by doctors, nurses and state healthcare agencies.  Least trusted (though frequently consulted) were social networking sites like Facebook or Twitter. Overall, the name of the law did not appear to affect the support for the law reported by the survey participants.  There was a significant main effect of parents’ political party on participants’ support for the law.

Conclusions:  The results of this study support literature that contends political association and party affiliation may influence support for the new healthcare law that received much media attention in fall 2013 (both positive and negative). This study contributes additional information about the influence of young adults’ parents upon their political beliefs, their support for social services programs, and potentially their support for the Patient Protection and Affordable Care Act (whether known by that name or by the sometimes-derogatorily applied “Obamacare”).

Implications for research and/or practice:  Understanding of the influence of parents’ beliefs upon their young adult children could be helpful in marketing the program, by targeting not just the desirable—low-risk—pool of healthy young adults who tend to avoid purchasing insurance, but targeting their parents as well to encourage their under-30 children to enroll in Healthcare.gov, especially when they age out of the coverage the law has already allowed parents to provide their offspring up to the age of 26.