Original Paper

Political Behavior

, Volume 37, Issue 1, pp 87-108

First online:

“Simply un-American”: Nativism and Support for Health Care Reform

  • Benjamin R. KnollAffiliated withDepartment of Politics, Centre College Email author 
  • , Jordan ShewmakerAffiliated withCentre College

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This study investigates the relationship between individual-level support for the 2010 Affordable Care Act and nativism, the perception that a traditional American culture and way of life needs to be protected against foreign influence. The results of an analysis of a 2011 public opinion survey demonstrate that nativism was an independent and significant predictor of opposition to health care reform and that this effect held for both Republicans as well as Democrats, although the relationship is stronger for Republicans. This is substantively important for two reasons. First, it demonstrates that certain sub-groups of the American public evaluate public policy proposals on the basis of their perceived “foreignness.” Second, it demonstrates that while nativism is traditionally associated with immigration and other race/ethnic-based policy preferences, it also affects attitudes toward other seemingly race-neutral policies in the United States.


Nativism Cultural threat Health care reform Affordable Care Act Elite framing