Race, Religion and Support for the Affordable Care Act


Using Pew Research Center’s Voter Attitudes Survey from 2012, we assess the impact race has on the relationship between religious faith and worship attendance with support for the Affordable Care Act (ACA). We find that White Evangelicals, independent of partisan affiliation and social-demographic characteristics, are more likely than White Non-Evangelicals to reject the ACA. In addition, among Whites, support for the ACA weakens with increasing religious attendance, suggesting that responses to this law are shaped by experiences within religious settings. However, we find little evidence for religious faith or worship attendance associating with Black and Hispanic health-care policy attitudes.

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  1. 1.

    We understand that all public opinion polls, Pew included, suffered declining response rates over the past 50 years. Between 1997 and 2018, the average telephone response rate at the Pew Research Center decline from 36 to 6% (Kennedy and Hartig 2019). However, this does not necessarily mean that the univariate responses in this survey are susceptible to response bias. Respondents in a 2017 Pew Research Poll were as likely to identify as Democrat, Republican, and Independent as respondents in the American National Election Studies and General Social Survey, both of which have response rates in the 70% range (Keeter et al. 2017). The Pew Study that we use attempts to correct for its lower response rates by weighting the sample based on the demographic statistics that are reported by the Census. We mention this because weighting data is an impactful means to reduce nonresponse bias (Dey 1997; Keeter et al. 2017).

  2. 2.

    See the appendix for full question wording of these measures.

  3. 3.

    We exclude “other races” (approximately 126 persons) from our analysis, as the data set does not contain further information about who is included in this group.

  4. 4.

    The following formula expresses the average treatment effect—a counterfactual causal effect—of the association between attending worship services and health care policy attitudes by estimating policy attitudes based on respondents being randomly assigned to attending worship services at least once a month and less than once a month. In the formula, E = average health care policy attitude of sample, Di  = variable of frequency of worship attendance, Yi  = policy attitude of respondent who attended worship services once a month or more, and Y0i  = policy attitude of respondent who attended worship services less than once a month. We replicated the same analyses with religious faith as the independent variable.

    \(E\left[ {Y_{ii} |D_{i} = \, 1} \right] - E\left[ {Y_{ii} |D_{i} = \, 0} \right] = E\left[ {Y_{1i} - Y_{0i} |D_{i} = 1} \right] = E\left[ {Y_{1i} - Y_{0i} } \right].\).

  5. 5.

    Because so few Blacks and Hispanics identify as secular or non-Christian, we combine these groups in the multivariate analyses of Tables 2 and 3.


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See the Table 4.

Table 4 Full survey questions on the Affordable Care Act

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Franz, B., Brown, R.K. Race, Religion and Support for the Affordable Care Act. Rev Relig Res (2020).

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  • Religion
  • Race/ethnicity
  • Affordable Care Act
  • Politics
  • Health care reform