Framing, Engagement, and Policy Change: Lessons for the ACA

Area of Science:

• Political Science
• Public Policy Analysis
• Health Policy Communication

Background:

• Supporters of the Patient Protection and Affordable Care Act (ACA) believe focusing on popular components can shift public attitudes.
• Existing research on framing effects suggests this strategy may be less effective than anticipated.
• Elite-level decision-making significantly influences the trajectory of major healthcare legislation like the ACA.

Purpose of the Study:

• To evaluate the effectiveness of framing versus engagement as rhetorical strategies for advancing the ACA.
• To extend the concept of engagement to the elite policy context surrounding the ACA.
• To explore how linking policy changes to opponents' broader goals can facilitate acceptance.

Main Methods:

• Analysis of scholarly literature on framing effects and political communication.
• Extension of engagement theory to the elite decision-making context.
• Case study analysis of debates surrounding sales taxes on electronic commerce for lesson drawing.

Main Results:

• Framing the ACA by highlighting popular components may not be as effective as engagement.
• Elite-level engagement requires connecting policy shifts to opponents' overarching philosophical and policy objectives.
• The debate over online sales taxes demonstrates how policy arenas can offer analogous strategies for political maneuvering.

Conclusions:

• Engagement, particularly at the elite level, presents a more promising strategy for advancing contentious policies like the ACA.
• Linking proposed policy changes to the broader goals of political opponents can overcome resistance.
• Lessons from seemingly unrelated policy debates, such as online sales taxes, can inform strategies for healthcare policy diffusion.