Do Major Policy Enactments Affect Public Evaluations of Congress?
The Case of Health Care Reform
David R. Jones
Professor of Political Science
Baruch College, City University of New York
david.jones@baruch.cuny.edu
Abstract
This study analyzes changes in individual evaluations of Congress immediately before
and after enactment of national health care reform in 2010. It tests three alternative hypotheses:
that enactment increased the likelihood of approval by demonstrating congressional competence;
that it decreased the likelihood of approval by calling attention to partisan processes; or that it
differentially affected citizens’ evaluations depending on their individual policy preferences. The
results show enactment polarized citizens’ evaluations of Congress, with supporters of the bill
increasing their approval of Congress and opponents decreasing. These findings represent the
first concrete evidence that enactments can affect evaluations of Congress.
[Forthcoming in Legislative Studies Quarterly, May 2013]
Enacting laws is Congress’s main job. Yet we still do not know whether enacting
landmark legislation affects citizens’ evaluations of Congress, or if so how. Understanding how
enactments affect evaluations of Congress is important because congressional evaluations have
significant effects of our political system. Attitudes towards Congress’s job performance cause
changes in citizens’ ideological leanings (Chanley, Rudolph, and Rahn 2000). They also affect
votes and outcomes in congressional elections (e.g., Jones and McDermott 2009). And they lead
to changes in the degree of trust in government (e.g., Citrin and Luks 2001; Gershtenson,
Ladewig, and Plane 2006). From a normative perspective, it would be troubling if the public’s
evaluations of Congress do not respond to major enactments, since this would appear to diminish
the incentives for elected officials to act in accordance with citizen preferences.
Most studies of the effect of major enactments on congressional approval have taken
place at the aggregate level, and have found little evidence of any overall impact. However,
literature in a closely related field—the impact of Supreme Court decisions on public support for
the Court—shows that the additional precision allowed by a shift from aggregate to individual
level analysis can sometimes lead to major new findings (e.g., Grosskopf and Mondak 1998;
Hoekstra 2000, 2003; Kritzer 2001). To date, this promising approach has yet to be fully applied
to the question of how enactments affect views of Congress. This is unfortunate given that
congressional evaluations have been shown to have at least as wide a range of consequences for
public opinion and behavior (e.g., effects on ideology, on trust in government, and on voting) as
do Supreme Court evaluations.
In an effort to advance understanding of how major enactments affect public evaluations
of Congress, this study adopts the individual-level, quantitative, case study approach that has
proven so informative in studies of the Supreme Court (e.g., Grosskopf and Mondak 1998;
1
Hoekstra 2000, 2003; Kritzer 2001). Specifically, I analyze how evaluations of Congress were
affected by enactment of national health care reform in 2010. In the remainder of this study, I
begin by reviewing the existing literature on how legislative actions affect public evaluations of
Congress. I then discuss the choice of health care reform as a case study, and lay out the specific
hypotheses to be tested. Next, I describe the data and method used in the study and present the
analysis. I conclude with a discussion of the theoretical and practical implications of the findings,
as well as avenues for future research.
Legislative Actions and Public Evaluations of Congress
The literature suggests three general theories of how congressional actions might affect
public evaluations of Congress.1 In this section, I present these general theories and then discuss
what we currently know and do not know based on existing empirical evidence.
At a basic level, when the Congress acts or fails to act this may send signals to the public
about its technical competence or effectiveness—its ability to get its job done. In politics,
competence is widely considered to be a “valence issue”, meaning that it is favored by
practically every citizen (Stokes 1963). In this case, evidence of a productive Congress as
opposed to one mired in gridlock should improve evaluations of Congress across almost all
citizens. Consistent with this conventional wisdom, Binder (2003, 117) posits that aggregate
evaluations of Congress will be affected, at least in part, by “what Congress accomplishes.” In
support of this general notion, empirical research finds that citizens’ perceptions of government
effectiveness increase approval of Congress (Mondak et al 2007), and a higher percentage of
legislative failures over a two-year period lowers average approval of Congress (Binder 2003).2
2
Another possibility is that a congressional action may increase the public’s focus on
process concerns. The public generally dislikes congressional processes, particularly partisan
conflict (Durr, Gilmour, and Wolbrecht 1997; Hibbing and Theiss-Morse 1995; 2002; Ramirez
2009). When major legislation is being debated in Congress, this debate—and the partisan
conflict that it often engenders—can be more salient than usual. If a major legislative action
results in increased attention to processes that are overly partisan for the public’s taste, this may
lower public approval of Congress. Consistent with this view, research finds that citizens’
perceptions of a discrepancy between preferred and actual governmental processes decreases
approval of Congress (Hibbing and Theiss-Morse 1995; 2002). Other research shows that
quarterly approval of Congress decreases during periods when there are more veto-override
attempts, which are inherently conflictual (Durr, Gilmour, and Wolbrecht 1997), and when there
are more votes divided along partisan lines (Ramirez 2009).
Finally, citizens may instead focus on a legislative action’s policy content. Classic
democratic theory argues that citizens prefer governments whose policy preferences are similar
to their own. According to Easton (1965), when people receive their desired policy outputs from
government, their support for government increases. In general, this outlook suggests that a
congressional action will boost evaluations among citizens who support the specific policy,
while lowering evaluations among citizens who oppose it. Consistent with this view, research
finds that individual citizens’ perceptions of overall policy discrepancy decrease their support for
Congress (Hibbing and Theiss-Morse 2002; Jones and McDermott 2009; Wlezien and Carman
2001).
While the literature reveals quite a bit about how evaluations of Congress are affected by
certain kinds of actions, by its inaction, and by perceptions of its actions, we still know very little
3
about how congressional evaluations respond to one of the most consequential actions of all: the
passage of major new legislation. The main approach to this question has been to analyze the
effect of the total number of major enactments in a quarter on aggregate approval ratings during
that quarter (Durr, Gilmour, and Wolbrecht 1997; see also Jones and McDermott 2009; Ramirez
2009; Rudolph 2002). Thus far, these efforts have not found any statistically significant effects
of enactments.3 The collective impression left by these studies is that the public simply does not
care about major enactments.
However, it is not possible to confidently infer how major enactments affect public
evaluations of Congress based on these existing data alone. Doing so would be subject to at least
two different types of inference problems. First, if certain kinds of enactments produce a
negative reaction and other kinds a neutral or positive reaction, an analysis that aggregates them
all together may find net effects to be insubstantial even if effects for specific types of
enactments are substantial. For example, the process-based theory implies that only enactments
characterized by high partisanship will have a negative effect, but aggregated measures of major
enactments likely include many bipartisan items, thus making inference problematic. Second, if a
given enactment is expected to produce a positive reaction among certain types of people and a
negative reaction among others, analysis of the aggregate reaction to that enactment may find no
net change even if most citizens’ opinions do change. For example, the policy-based theory
implies that citizens who favor a bill will have the opposite reaction to its enactment than those
who oppose it, but in an aggregated measure of public evaluations these effects may wash out,
again making inference problematic. Recognizing some of these potential limitations, Ramirez
(2009) concludes his aggregate study noting that “given the great deal of heterogeneity at the
4
individual level, future research may uncover more complex relationships among subaggregates
of the public.”
Indeed, the closely-related literature on public reactions to Supreme Court decisions
shows that where aggregate studies produced null findings, studies of specific decisions that
analyzed individual level opinions found significant effects of these decisions on public
evaluations of the Court (e.g., Grosskopf and Mondak 1998; Hoekstra 2000, 2003; Kritzer 2001).
To date, this disaggregated approach has generally not been applied to the question of
how enactment of laws affects evaluations of Congress. One exception (of which I am aware) to
this rule takes the form of a telephone survey experiment.4 In this survey experiment,
conservatives who were told that Congress had recently passed a liberal enactment—a
supplemental appropriations bill increasing federal Medicare spending—were less likely to
approve of Congress than were conservatives who were not told, while very liberal respondents
who were told about the same enactment were more likely to approve of Congress than were
very liberal respondents who were not told (Jones and McDermott 2009, pp. 22-31). While this
study offers some support for the policy-based theory, the artificial aspects of its experimental
design (a verbal stimulus as opposed to real world stimulus) limit its external validity. In order to
provide a more appropriate test of existing theories and obtain a more complete understanding of
the effect of enactments on evaluations of Congress, what is needed is analysis of an actual
policy enactment.
5
Enactment of Health Care Reform
In this section, I provide brief background on congressional passage of health care
reform, discuss its appropriateness as a case study for this research, and derive three specific
hypotheses to be tested.
The particular piece of legislation used in this analysis is the enactment of national health
care reform in 2010. Congress gave final approval to the Patient Protection and Affordable Care
Act on March 21, 2010. The law overhauls the nation’s health care system, extending access to
more than 30 million people by expanding Medicaid and providing federal subsidies to help
lower and middle-income Americans buy private coverage. It requires most Americans to have
health insurance coverage, and regulates private insurers more closely than they were previously.
There are several reasons this particular bill is useful for analyzing the theories at issue in
this study. First, all of the theories discussed in the literature section are arguments about how
citizens use information they receive about an enactment. However, the public is often unaware
of what legislators are doing (e.g., Stokes and Miller 1962) and thus ordinary enactments would
not permit testing of these theories. Meaningful testing requires an enactment on which public
attention was high. With three quarters of the public reporting following the story closely during
the week it passed, enactment of health care reform clearly meets this standard.5
Second, a fair test of the competency-based theory—that the public will respond
positively when Congress demonstrates that is can accomplish something of consequence—
requires selection of an enactment that is widely seen to be important. Enactment of health care
reform clear fits this description. Universal health care coverage had been a longstanding issue in
American national politics since at least as far back as 1932 (Igel 2008). Not surprisingly, then,
6
news outlets were nearly unanimous in declaring the passage of health care reform to be a
momentous event in the history of congressional lawmaking (e.g., Hitt and Adamy 2010).
Third, a fair test of the process-based theory requires a bill whose enactment process was
highly partisan and conflictual. The vote on final passage of health care reform received no
support from Republican members, passing only with votes of Democrats (D: 219-34; R: 0-178).
During the final passage debate, a series of Republican members angrily denounced the bill on
the floor of the House—with Republican Minority Leader John Boehner at one point shouting,
“Hell no!” during his closing speech. In the news media, Republican members complained that
Democrats “rammed health care down our throats” and denounced legislative procedures used by
the Democrats, such as reconciliation, that limited the possibility of Republican input. This
partisan rancor was widely reported in the press (e.g., Garber 2010).
Fourth, to help distinguish the predicted conditional effects of the policy-based theory
from the predicted uniform effects of the other theories it is useful that public opinion on the
selected bill not be completely one-sided, but instead contain a reasonable degree of variation
across citizens. A poll taken shortly before enactment demonstrates that this was the case for
health care reform: 48% opposed the bill, 37% supported it, and the remainder had no opinion.6
Finally, in order to rule out alternative explanations for any changes in public evaluations
of Congress that are observed after enactment, it is important to select an enactment that took
place when virtually no other significant events were occurring in the national government.
According to content analysis of news coverage conducted by the Pew Research Center’s Project
for Excellence in Journalism, “health care reform dominated the news” during the period
included in this analysis (Holcomb et al 2010).7 Overall, given the nature of the theories to be
7
tested, enactment of health care reform is a case study that is particularly well-suited to the task
at hand.
In addition to providing leverage on the theoretical issues at hand, the case study also
sheds new light on the passage of health care reform as an important historical event in its own
right. For example, as of this writing, significant efforts are being made to repeal the health care
law. Part of the rationale for this repeal is the notion that people were unhappy with Congress for
passing it in the first place (Halloran 2010). By systematically analyzing actual changes in
evaluations of Congress surrounding enactment of health care reform, this study provides some
additional perspective to these repeal efforts.
Applying the general theories from the previous section to the case of the 2010 health
care reform bill’s enactment, I propose three specific hypotheses. If citizens were primarily
concerned with the legislation’s policy content, then its enactment should increase support for
Congress among those who favor the bill, decrease support among those who oppose the bill,
and have no predicted effect for those without a policy preference. If citizens viewed the
enactment simply as evidence of the Congress’s competence, then enactment should increase
support for Congress, regardless of a citizen’s policy views. Finally, if citizens were primarily
concerned with the level of partisanship in the process of this enactment—and if enactment
increased perceptions of congressional partisanship—then enactment should decrease support for
Congress, regardless of a citizen’s policy views.8
Data and Method
This study adopts the disaggregated methodological approach of the type employed in
existing studies of Supreme Court approval (e.g., Grosskopf and Mondak 1998; Hoekstra 2000,
8
2003; Kritzer 2001). I conduct an individual-level analysis of pooled, cross-sectional public
opinion surveys conducted at close intervals before and after enactment of health care reform.
Specifically, I employ a pair of surveys conducted by CBS News on March 18-21, 2010
(immediately prior to enactment) and on March 29-April 2, 2010 (one week after enactment).9
Consistent with comparable research elsewhere, I pool the pre-enactment survey with the postenactment survey so that each variable—including the dependent variable of interest here,
congressional evaluations—contains responses taken both before and after enactment.
Congressional evaluations are measured using the question, “Do you approve or disapprove of
the way Congress is handling its job?” with those who approve coded 1, those who disapprove
coded -1, and “don’t know” responses coded 0.
To test for effects of enactment, I create a dummy variable coded 0 for every observation
taken before enactment and 1 for every observation taken after enactment. While the “evidence
of competence” hypothesis predicts a positive coefficient for this post enactment variable and the
“partisan amplification” hypothesis predicts a negative coefficient, the “policy performance”
hypothesis predicts differential effects of enactment depending on each citizen’s policy
preference regarding health care reform. Therefore, I also interact the enactment variable with a
variable representing each citizen’s health care policy preference.10
The fact that the dataset is comprised of pooled independent cross sections as opposed to
a panel survey raises a possible risk of spurious findings. For example, if the results were to
show that those who supported the health care bill were more likely to approve of Congress after
enactment than before enactment, this could mean one of two things. On the one hand, such
results could occur because enactment led citizens who consistently supported health care reform
to increase their approval of Congress. However, research also suggests that citizens may change
9
their issue opinions in response to cues from political elites (e.g., Lupia and McCubbins 1998).
Thus these same results could occur if enactment of health care reform—and congressional
leaders trumpeting it as a signature accomplishment of Congress—led citizens who consistently
approved of Congress to increase their support for health care reform. In other words, such
results could potentially be spurious due to reverse causality.
While no panel survey asked the same respondents about approval of Congress both
before and after enactment of health care reform, it is still possible to rule out the possibility of
reverse causality by demonstrating that citizens’ prior evaluations of Congress did not lead to
subsequent changes in their health care preferences. There does exist a post-enactment survey of
the same respondents to CBS’s March 18-21 (pre-enactment) survey, which—while it does not
ask for their post-enactment evaluation of Congress (preventing its use in the main analysis
here)—does ask for their post-enactment preference on health care. Regression analysis of these
respondents found that individuals’ pre-enactment evaluations of Congress did not produce any
systematic changes in their health care preferences after enactment compared to before. In other
words, approvers of Congress did not become more likely to favor health care reform and
disapprovers did not become more likely to oppose health care reform (see appendix for details).
Since congressional evaluations did not affect subsequent health care preferences, then the causal
arrow for any interactive relationship found in the analysis would have to run from policy
preference to congressional evaluation, as originally hypothesized.
I also take other steps to guard against the possibility of spurious findings. First, I tested
for, and was able to rule out, any differences in the demographic composition of the pre and post
cross sections. While it is technically not necessary to include demographic controls in a research
design of this type (Achen 1986), for additional confidence I include controls for basic
10
demographic variables such as education, race, and gender.11 Second, I control for standard
attitudinal variables thought to affect congressional approval. These include citizens’ perceptions
of the economy12, party identification, and ideology. Additionally, since citizens’ evaluations of
the president are thought to influence their evaluations of Congress, the model also controls for
approval of Obama.13 The appendix includes details on the data and the coding of all variables.
Analysis
To account for the ordinal nature of the dependent variable, I use ordered logistic
regression to analyze the data. I first test for an overall effect of enactment. In this initial model,
the key coefficient is the “post enactment” variable. Next, I test for a conditional relationship
between enactment and policy preference. I test for this conditional relationship by adding a term
representing the interaction between the enactment variable and the variable measuring each
citizen’s preference on the health care bill. If the post-enactment variable displays a significant
positive effect on evaluations in both models, with no conditional effects, this would support the
idea that citizens primarily perceived the enactment as evidence of congressional effectiveness
(competence). If the post-enactment variable displays a significant negative effect on evaluations
in both models, with no conditional effects, this would support the idea that citizens primarily
reacted to the partisan bickering surrounding the enactment. If the interactive term in the second
model is positive and significant, this would support the idea that citizens were primarily
concerned with whether or not the enactment moved national policy closer to their preferences.
Finally, if the post enactment variable does not display any significant effects, either main or
conditional, this would support the idea that enactment of major legislation has no impact on
public evaluations of Congress.
11
Table 1 presents the results of estimating these models of congressional evaluations. In
model 1, the insignificant coefficient for the post enactment variable indicates that enactment of
health care reform had neither a uniformly negative effect on evaluations of Congress nor a
uniformly positive effect on evaluations of Congress. The fact that the coefficient is not
significantly positive means that the results offer no clear support for the “demonstration of
competence” hypothesis. In other words, citizens did not primarily view enactment as an
indicator of Congress’s ability to do its job or not. The fact that the coefficient is not significantly
negative means that the results also offer no clear support for the “partisan amplification”
hypothesis. In other words, either citizens were not primarily focused on the partisan nature of
the bill’s passage or the passage did little to increase their pre-existing views of Congress as
partisan.
[Table 1 about here]
Model 2 adds a term representing the interaction between the enactment variable and the
variable measuring whether a citizen’s opinion of health care reform was unfavorable (-1),
favorable (1), or “don’t know” (0). This particular coding means that coefficient for the postenactment variable now represents the effect of enactment among citizens without a policy
preference on the bill, while the coefficient for the interaction term simultaneously represents the
direct effect of enactment among policy supporters and the inverse effect of enactment among
policy opponents. If this variable is significant, it would indicate a conditional rather than a
uniform effect of health care reform’s enactment.
The results from model 2 make clear that the effects of enactment are in fact conditional
on a citizen’s policy preference. The original post-enactment coefficient remains insignificant in
the new model, indicating that citizens without a policy preference were largely unaffected by
12
enactment. In contrast, the coefficient for the interactive term is significantly positive and a chisquare test confirms that adding this interaction significantly improves the fit of the model. The
positive coefficient means that those in favor of health care reform evaluated Congress more
positively after enactment, while those opposed to health care reform evaluated Congress more
negatively after enactment. In other words, consistent with the policy performance hypothesis,
citizens’ reactions to enactment of health care reform were based primarily on whether the
enactment moved policy closer to or farther away from their personal policy preferences.
To the extent that health care preferences are correlated with partisanship, a possible
concern is that the interactive effects in model 2 may actually reflect some other partisan effect
going on during this time frame, not a true concern about the specific policy that was enacted
(Kimball 2005). To guard against this potential inference problem, I first checked the degree to
which respondents’ policy opinions reflected their partisanship. In fact, partisanship explains
only 18.6 percent of the variance in citizens’ health care opinions.14 Second, to rule out the
possibility that the interactive effects in model 2 are nonetheless being driven by this mild
connection to partisanship, I added to the model a variable representing the interaction between
party identification and post-enactment status. However, the presence of this variable does not
affect the significance of the health care preference interaction and offers no significant
improvement in the model.15 Similarly negative results are obtained when a variable representing
the interaction of ideology and post-enactment status is added (results not shown). These tests
make clear that the changes in citizens’ evaluations of Congress after enactment are not a
function of their party identification or general ideological outlook, but instead are a function of
their policy preferences on the specific issue of health care reform.
13
Another question regards the relative magnitude of (positive) effects among supporters
compared to the magnitude of (negative) effects among opponents. The interactive variable is
constructed under the assumption there is no a priori reason to expect one effect to be of greater
absolute magnitude than the other. In other words, it assumes that the degree of one’s
disappointment with passage of an unwanted policy change is largely similar to the degree of
one’s pleasure with passage of a desired policy change. As one check on this assumption, the
third and fourth models in Table 1 separately estimate the effect of enactment among just
supporters of the health care bill and among just opponents. The results continue to show
significant effects of enactment in the expected direction for each group. While, the absolute size
of this effect appears slightly larger among opponents of the health care reform bill than among
supporters, the confidence intervals around each estimate indicate that this difference is not
statistically significant.
Looked at from a slightly different perspective, the results in table 1 also speak to the
change in the importance of health care opinions in explaining evaluations of Congress. Because
of the way the variables are constructed, the coefficient for “health care opinion” in model 2
represents the estimated effect of health care opinions prior to enactment. The fact that it is not
significant means that before Congress enacted the bill, a person who favored health care reform
was statistically no more favorable towards Congress than a person who opposed health care
reform (after controlling for other factors such as evaluations of Obama). However, the fact that
the interactive variable is significantly positive means that after Congress enacted the bill,
supporters of health care reform did become significantly different from opponents of health care
reform in their views towards Congress.
14
Figure 1 provides an illustration of the substantive impact of enactment, based on the
estimates from the full model (model 2). For those who supported the health care reform bill and
for those who opposed it, the figure shows the estimated likelihood of approving of Congress
after enactment (right side) compared to before enactment (left side).16 Consistent with the
finding that health care opinion was not a significant predictor of congressional evaluations
before enactment, the figure shows that supporters of health care reform were estimated to be
only 4.8 points more likely to approve of Congress than opponents were in this earlier period.
But the figure also illustrates how enactment of health care caused citizens’ evaluations of
Congress to polarize along the lines of policy preference. Among supporters of health care
reform, enactment resulted in an estimated 8.7-point increase in approval of Congress. Among
opponents of health care reform, enactment had the opposite effect, decreasing approval of
Congress by an estimated 1.9 points. As a result, after enactment, supporters of health care
reform had become significantly more likely than opponents to approve of Congress.
Specifically, the estimated difference in approval between the two groups increased more than
threefold, to 15.4 points.
[Figure 1 about here]
While figure 1 is useful for illustrating some of the key aspects of the analysis, in at least
one respect, it may be slightly misleading. From the results of the full statistical analysis we
know that the enactment had essentially the same magnitude of effect on the log odds of
approval among supporters of health care as among opponents (albeit in opposite directions).
Visually, however, figure 1 makes it appear that enactment had a much stronger effect among
supporters of health care reform than among opponents. This seeming discrepancy is actually
due to the fact that the regression’s logit function necessarily follows an s-shaped curve, which is
15
steeper towards the center and flatter at each end (see Long 1997). In other words, for a person
who is already very unlikely to approve of Congress, it is much more difficult to make that
person even less likely to approve than it is to make that person more likely to approve.
Discussion
The results of this study carry important implications for study of legislative enactments
and public opinion in general, and also the passage of health care reform specifically. First,
existing research has led to the impression that even major enactments do not have any effect on
what citizens in our democracy think about the performance of their legislative branch. In
contrast to this normatively troubling notion, this study is the first to find significant effects of an
actual enactment on individuals’ evaluations of Congress.
Second, the analysis reveals that an important causal mechanism driving individual
changes in public evaluations of Congress in response to an enactment is citizens’ desire for
policy representativeness. Rather than having a simple uniform effect across the population,
reactions can differ dramatically depending on each citizen’s policy views. Specifically, those in
favor of a policy change may increase their approval of Congress once it is enacted into law,
while those opposed to the policy change may decrease their approval. While the effect of any
one enactment may not be overly dramatic, research elsewhere suggests that the cumulative
effect of a series of congressional policy actions with a consistent ideological bent may be quite
substantial (Jones and McDermott 2009).17
Regarding the politics of health care reform specifically, the results suggest this
enactment may have had a more complex effect than previously thought. Contrary to perceptions
in some quarters, the results presented here do not provide any evidence that enactment of health
16
care reform affected overall approval of Congress either negatively or positively (the main effect
of enactment was insignificant). On the other hand, enactment may have helped to “solidify the
base” for both parties in advance of the 2010 midterm elections. Supporters of health care
reform—already likely to be liberal and Democratic—became more supportive of Congress after
enactment. Given research showing that higher approval of Congress boosts voting for
candidates from the majority party (Jones and McDermott 2009), their increased support for
Congress may have in turn made them even more likely to vote for Democrats in November.
Opponents of the bill—already likely to be conservative and Republican—became less
approving of Congress, and therefore possibly even less likely to vote for Democratic candidates.
Since these changes in preferences occurred on both sides of the political divide, they are
unlikely to have been a driving factor in Republicans’ sweeping election victory (which most
analysts attribute to the poor economy). However, this increase in intensity of preferences could
help explain why voter turnout in 2010 was the highest for any midterm election in the previous
16 years.18
In discussing how much can be generalized from the case of health care reform, one
caveat is that unlike most of the laws passed in each Congress, this was a major, salient piece of
legislation. Indeed, the effects of enactment are likely to be much less robust for less important
legislation, on which Americans pay less attention and are less opinionated. The question then
becomes whether health care reform is unusual in its salience, and therefore not a case from
which one can generalize, or whether other major legislation shares high levels of public
attention as well. As a rough check, I investigated the salience of laws considered by Mayhew
(2005) to be “landmark legislation” in the 16 years prior to 2009. During these eight Congresses,
at least nine landmark enactments were salient to a majority of the general public—an average of
17
more than one per Congress.19 In addition, the literature provides evidence that the public is
more likely to attribute responsibility for legislative enactments to Congress than to the president
(e.g., Jones and McDermott 2009). Taken together, these observations suggest that while the
policy performance hypothesis may not be applicable to most congressional action, there remain
many significant enactments besides health care on which citizens’ policy concerns could affect
their evaluations of Congress.
It is also important to note that while the results of this study did not find clear support
for the competence or partisan processes hypotheses, neither can the results be taken as evidence
against the relevance of these factors for congressional evaluations. While competence and
partisan processes may not have been the key evaluative dimensions driving reactions to this
particular event, one or both may still play an important role in explaining the overall
unpopularity of Congress relative to the Supreme Court and the president (Hibbing and TheissMorse 1995). Hyper-partisan processes and the seeming incompetence of legislative gridlock are
generally the norm in Congress, while passage of important legislation is a more sporadic event.
As such, these ever-present, negative conditions may be more useful than the immediate degree
of policy performance in explaining the underlying low level of approval in Congress. On the
other hand, policy performance may be more useful than the other two factors in explaining
variations from that low baseline.20
Finally, this project suggests avenues of future research. On the single case study
analyzed here, the net result of micro-level changes in public evaluations of Congress was
negligible. But under alternative contextual conditions, the theory could also be consistent with
enactments producing aggregate changes as well. For example, where support for a bill is more
homogeneous or more intense, aggregate approval of Congress might be expected to rise. And in
18
cases where opposition to a bill is more prevalent or more intense, overall approval of Congress
might be expected to decline. Future studies should attempt to test these further implications of
the theory across a variety of other legislation and other contexts.
19
Appendix
Ruling out Reverse Causality
As discussed in the “Data and Method” section, it is important to rule out the possibility that
initial (pre-enactment) opinions of Congress produced any systematic post-enactment changes in
health care opinions. I accomplish this through ordered logistic regression analysis of a panel
survey. The first wave of the panel is from the same pre-enactment survey used in the main
analysis (March 18-21 CBS poll), and the second wave was conducted after enactment, March
22-23. Question wording and coding remains the same as in the main analysis (see below). The
dependent variable is an ordinal measure of each individual’s change in opinion on health care
reform (post-enactment opinion minus pre-enactment opinion), and runs from -2 (became less
supportive) to +2 (became more supportive). The model controls for regression artifacts—the
tendency for extreme values to become less extreme on subsequent measurement—by including
a measure of initial health care opinion (Markus 1990; this coefficient is expected to be
negative).21 The key variable is one’s initial evaluation of Congress. If initial opinions of
Congress led people to adjust their health care opinions after learning that Congress passed the
bill, this variable would be significant and positive. In fact, the results in table A1 demonstrate
that there is no such effect. This negative finding is consistent with the alternative causal
argument made in this paper.
[Table A1 about here]
Data Coding and Details for the Main Analysis
Evaluation of Congress: “Do you approve or disapprove of the way Congress is handling its
job?” Approve = 1; disapprove = -1; don’t know = 0. Evaluation of president: “Do you approve
or disapprove of the way Barack Obama is handling his job as president?” Approve = 1;
20
disapprove = -1; don’t know = 0. Economic sentiment: residual of citizens’ evaluations of the
president’s handling of the economy after controlling for their overall evaluations of the
president (see note 12). Democrat: dummy variable coded 1 for Democrats, 0 otherwise.
Republican: dummy variable coded 1 for Republicans, 0 otherwise. Ideology: “How would you
describe your views on most political issues?” Liberal = 1; moderate/don’t know = 0;
conservative = -1. Education: Not a high school graduate = 1; high school graduate = 2; some
college = 3; college graduate = 4; Post graduate work = 5. Black: black = 1; else = 0. Female:
female = 1; else = 0. Health care bill opinion: “From what you’ve heard or read, do you approve
or disapprove of the current health care reform bill?” Approve = 1; disapprove = -1; don’t know
= 0. Post enactment: post enactment = 1; pre enactment = 0. Note: Surveys conducted by CBS
News March 18-21 and March 29-April 2, 2010 using landline and cellular telephone interviews
with national samples of 1,026 and 1,059 adults selected using modified probability sampling.
21
Endnotes
1
In addition to these three theories regarding direct effects, legislative actions may indirectly
affect public evaluations to the extent that these actions affect national conditions such as the
state of the economy (Arnold 1990). The analysis controls for economic sentiment.
2
The construction of Binder’s independent variable means that its effects could be more a
function of what does not get done than of enactments per se.
3
Durr, Gilmour, and Wolbrecht (1997) report a negatively-signed coefficient, but this
relationship fails to reach standard levels of statistical significance (p<.06, one-tailed).
4
Another similar study is Haider-Markel and Carr (2007). The authors study the impact of the
push to enact a federal law intervening in the Teri Schiavo case on evaluations of government.
However, their analysis does not include data from after the enactment, and does not test for
differential effects across individuals.
5
CBS News survey conducted March 18-21, 2010.
6
CBS News survey conducted March 18-21, 2010.
7
Health care reform was the top story across all news formats, comprising between one-third and
one-half of all news coverage, while the second ranked story (the economy) comprised less than
one-tenth of all news coverage.
8
A failure to find this effect would not necessarily mean that partisanship is unimportant. It
could also mean that the public already viewed Congress as so partisan that the attention brought
by enactment did little to increase such perceptions. Distinguishing between these two
interpretations is difficult because a search of the Roper Center’s iPOLL database found no
comparable survey questions regarding public perceptions of congressional partisanship in the
month before enactment versus the month after enactment.
22
9
Respondents who were called on the same day the bill was passing (March 21) are removed
from the analysis (13% of cases).The surveys do not contain questions regarding general
favorability towards each party in Congress, or favorability towards each party overall. Details
on the surveys are included in the appendix.
10
The surveys do not permit analysis of whether the effect is any different for those who
opposed the bill because they thought it did not go far enough as compared to those opposed
because it went too far.
11
Controls for income and age were also tested, but were removed from the final model because
they were not significant.
12
There is no evidence of any clear economic trend during this narrow time period. Between
March and April, the Conference Board’s Consumer Confidence Index rose, the University of
Michigan’s Consumer Sentiment Index fell, and unemployment remained stable. Because the
survey contained no direct measure of economic attitudes, this control variable is measured as
the residual of citizens’ evaluations of the president’s handling of the economy after controlling
for their overall evaluations of the president.
13
The results are substantively similar regardless of whether or not this control is included.
14
Specifically, an ordinal logistic regression of health care bill opinions on partisanship produces
a Nagelkerke pseudo R-square of .186.
15
None of the independent variables in this model had a Variance Inflation Factor higher than
3.5, suggesting no substantial multicollinearity problems.
16
All other variables are held constant at their group mean. For visual clarity, I omit the
insignificant effects for those with no opinion on health care.
23
17
For this larger point to be true, though, it is important to first provide micro-level evidence that
a single enactment can have an effect, as done here.
18
According to the United States Election Project, turnout was 40.9 percent in 2010.
19
Public opinion data on congressional activity becomes very thin prior to 1993. Mayhew (2005;
dataset extended at http://pantheon.yale.edu/~dmayhew/data3.html) identifies 13 landmark
enactments during 1993-2008. In 11 of these cases, I was able to find polls asking citizens if they
followed the legislation closely or if they knew whether the law passed. Nine of the laws were
salient to a majority. Two were salient to more than 40% but less than 50%. Specifically -Deficit Reduction, 1993: 66% followed (Times Mirror, 7/29-8/1/1993); NAFTA, 1993: 73%
followed (Times Mirror, 12/2-5/1993); Telecommunications Act, 1996: 43% followed (Pew
2/22-25/1996); Welfare Reform, 1996: 67% followed (Kaiser, 8/5-7/1996); Balanced Budget,
1997: 75% knew (Pew, 8/7-10/1997); Bush Tax Cut, 2001: 69% heard (CBS, 4/23-25/2001); Use
of Force, 2001 (no salience poll); USA PATRIOT Act, 2001: 53% knew (NPR, 10/3111/12/2001); Homeland Security Department, 2002: 49% knew (Pew 12/4-8/2002); Use of Force
in Iraq, 2002: 88% followed (Pew 10/2-6/2002); Medicare Reform, 2003: 65% followed (Kaiser,
12/3-7/2003); Housing Relief, 2008 (no salience poll); Troubled Asset Relief Program, 2008:
88% followed (Pew, 10/3-6/2008).
20
In fact, given the constant background drumbeat of negative stories about Congress in the
media, it is all the more surprising to find, as demonstrated here, that a single event can shift
individuals’ opinions of Congress at all. Note that this stands in contrast to studies of the
Supreme Court. The public hears almost nothing about the Court except for its major rulings.
Therefore, these rulings would more readily be expected to have an impact on its public
evaluations than enactments would for Congress’s.
24
21
Results are similar regardless of whether or not this control is included.
25
References
Achen, Christopher H. 1986. The Statistical Analysis of Quasi-Experiments. Los Angeles:
University of California Press.
Binder, Sarah A. 2003. Stalemate: Causes and Consequences of Legislative Gridlock.
Washington DC: Brookings.
Chanley, Virginia A., Thomas J. Rudolph, and Wendy M. Rahn. 2000. “The Origins and
Consequences of Public Trust in Government: A Time Series Analysis.” Public Opinion
Quarterly 64 (3): 239-256.
Citrin, Jack and Samantha Luks. 2001. “Political Trust Revisited” Déjà Vu All Over Again?.” In
John R. Hibbing and Elizabeth Theiss-Morse, ed., What is it About Government that
Americans Dislike? New York: Cambridge University Press, pp. 9-27.
Durr, Robert H., John B. Gilmour, and Christina Wolbrecht. 1997. “Explaining Congressional
Approval.” American Journal of Political Science 41(1): 175–207.
Easton, David. 1965. A Systems Analysis of Political Life. New York: Wiley.
Garber, Kent. 2010. “After Months of Debate, No Bipartisanship on Healthcare.” US News and
World Report, March 22.
Gershtenson, Joseph, Jeffrey Ladewig, and Dennis L. Plane. 2006. “Parties, Institutional Control,
and Trust in Government.” 2006. Social Science Quarterly 87 (4): 882-902.
Grosskopf, Anke, and Jeffrey Mondak. 1998. “Do Attitudes Toward Specific Supreme Court
Decisions Matter? The Impact of Webster and Texas v. Johnson on Public Confidence in
the Supreme Court.” Political Research Quarterly 51 (3): 633-54.
Haider-Markel, Donald P., and Carol Carr. 2007. “The Political Fallout of Taking a Stand: The
President, Congress, and the Schiavo Case.” Presidential Studies Quarterly 37: 449–467.
26
Halloran, Liz. 2010. “Pew Poll: Trust in Government Hits Near-Historic Low.” NPR, April 18.
Hibbing, John R., and Elizabeth Theiss-Morse. 1995. Congress as Public Enemy: Public
Attitudes towards American Political Institutions. New York: Cambridge.
Hibbing, John R., and Elizabeth Theiss-Morse. 2002. Stealth Democracy. Cambridge:
Cambridge University Press.
Hitt, Greg and Janet Adamy. 2010. “Congress Passes Historic Health Bill.” Wall Street Journal
March 22.
Hoekstra, Valerie J. 2000. The Supreme Court and Local Public Opinion.” American Political
Science Review 94 (1): 89-100.
Hoekstra, Valerie J. 2003. Public Reaction to Supreme Court Decisions. New York: Cambridge
University Press.
Igel, Lee. 2008. “The history of health care as a campaign issue.” Physician Executive 34 (3):
12–15.
Jones, David R. and Monika L. McDermott. 2009. Americans, Congress, and Democratic
Responsiveness: Public Evaluations of Congress and Electoral Consequences. Ann
Arbor, MI: The University of Michigan Press.
Kimball, David C. 2005. “Priming Partisan Evaluations of Congress.” Legislative Studies
Quarterly 30 (1): 63-84.
Kritzer, Herbert. 2001. “The Impact of Bush v. Gore on Public Perceptions and Knowledge of
the Supreme Court.” Judicature 85: 32-38.
Long, J. Scott. 1997. Regression Models for Categorical and Limited Dependent Variables.
Thousand Oaks, CA: Sage.
27
Lupia, Arthur and Mathew D. McCubbins. 1998. The Democratic Dilemma: Can Citizens Learn
What They Need to Know? New York: Cambridge University Press.
Markus, Gregory. 1990. Analysis of Panel Data. Sage University Paper on Quantitative
Applications in Social Science, 07-018.
Mayhew, David R. 2005. Divided we Govern: Party Control, Lawmaking, and Investigations
1946-2002, 2nd ed. New Haven, CT: Yale University Press.
Mondak, Jeffery J, Edward G. Carmines, Robert Huckfeldt, Dona-Gene Mitchell, Scot
Schraufnagel. 2007. “Does Familiarity Breed Contempt The Impact of Information on
Mass Attitudes toward Congress.” American Journal of Political Science 51(1): 34-48.
Holcomb, Jesse, Vadim Nikitin, Laura Santhanam, and Tricia Sartor. 2010. “Health Care Reform
Sweeps Capitol and the Media.”
www.journalism.org/index_report/pej_news_coverage_index_march_2228_2010
(October 15, 2011).
Ramirez, Mark. 2009. “The Dynamics of Partisan Conflict on Congressional Approval.”
American Journal of Political Science 53 (3): 681-694.
Rudolph, Thomas J. 2002. “The Economic Sources of Congressional Approval.” Legislative
Studies Quarterly 27(4): 577–99.
Stokes, Donald E. 1963. “Spatial Models of Party Competition.” American Political Science
Review 57 (2): 368-377.
Stokes, Donald E., and Warren E. Miller. 1962. “Party Government and the Saliency of
Congress.” Public Opinion Quarterly 26 (4): 531-46.
Wlezien, Christopher, and Christopher Carman. 2001. “Ideological Placements and Political
Judgments of Government Institutions.” Public Opinion Quarterly 65 (4): 550–61.
28
Table 1:
Effect of Health Care Enactment on Evaluations of Congress
Independent Variables
Presidential evaluation
Economic sentiment
Democrat
Republican
Ideology
Education
Black
Female
Health care bill opinion
Post enactment
Post enactment X hc opin.
-2 Log Likelihood
χ2 test of model difference
Number of cases
All
.413**
.311**
-.234
.120
.073
-.357**
.459**
.414**
.056
.155
1927.13
1645
(.093)
(.100)
(.146)
(.167)
(.083)
(.055)
(.168)
(.119)
(.082)
(.118)
All (Conditional)
.400**
(.093)
.362**
(.106)
-.199
(.147)
.120
(.168)
.089
(.083)
-.369**
(.056)
.444**
(.169)
.424**
(.119)
-.151
(.109)
.168
(.118)
.388**
(.131)
1918.59
8.54**
1645
Among Bill Supporters
-.012
(.178)
.273
(.123)
-.414*
(.226)
.132
(.361)
-.138
(.140)
-.167*
(.087)
.916**
(.229)
.014
(.198)
.368*
(.199)
Among Bill Opponents
.698**
(.134)
.401**
(.149)
.600*
(.263)
-.168
(.259)
.138
(.149)
-.458**
(.102)
-1.259**
(.421)
.457*
(.201)
-.447*
(.201)
617.11
701.20
560
822
Note: Polls conducted March 18-21 and March 29-April 2, 2010 (see appendix for details). Table entries are ordered logistic regression coefficients (standard
errors in parentheses). *p<.05 **p<.005 (one-tailed)
29
Table A1:
Effect of Initial Evaluations of Congress on Change in Health Care Opinions
Independent Variables
Initial opinion on health care
Initial evaluation of Congress
-2 Log Likelihood
Number of cases
Coefficient
-.955**
-.032
(standard error)
(.140)
(.169)
265.86
495
Note: Panel survey conducted March 18-21 and again March 22-23, 2010. Table entries are ordered logistic
regression coefficients (standard errors in parentheses). *p<.05 **p<.01
30
Figure 1:
Estimated Impact of Health Care Enactment on Approving of Congress
Note: Calculated from table 1, model 2. See text for details.
31