Abstract
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.
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Notes
It should be noted that framing an issue as “un-American” does not necessarily imply in every case a nativist judgment on the part of the message’s framer. A quick internet search of the phrase “un-American” quickly reveals how commonly and diversely this phrase has come to be used in modern political rhetoric. At the same time (and importantly for our study), the phrase “un-American” can certainly cue nativist responses on the part of the message’s recipients regardless of the intention of the message’s sender/framer.
We also estimated these models using a multinomial logit estimator as well as the original ordinal logit estimator. Both estimations produced the same substantive results for the key independent variables as presented here in Table 3.
This is a similar approach to that employed by Kam and Kinder (2012) in their analysis of the mediating effects of racial resentment and religious intolerance on the relationship between ethnocentrism and evaluations of President Obama.
References
ABC News. (2010). Clinton calls Koran burning plan ‘outrageous,’ urges church to cancel. ABC News Blogs. Retrieved July 23, 2012 from http://abcnews.go.com/blogs/politics/2010/09/clinton-calls-koran-burning-plan-outrageous-urges-church-to-cancel/.
Alvarez, R. M., & Butterfield, T. L. (2000). The resurgence of nativism in California? The case of proposition 187 and illegal immigration. Social Science Quarterly, 81(1), 167–179.
Arbour, B. K., & Teigen, J. M. (2011). Barack Obama’s ‘American’ problem: Unhyphenated Americans in the 2008 elections. Social Science Quarterly, 92(3), 563–587.
Banks, A. J. (2013). The public’s anger: White racial attitudes and opinions toward health care reform. Political Behavior. doi:10.1007/s11109-013-9251-3.
Barreto, M. A., Cooper, B. L., Gonzalez, B., Parker, C. S., & Towler, C. (2011). The tea party in the age of Obama: Mainstream conservatism or out-group anxiety? Political Power and Social Theory, 22, 105–137.
Bennett, David H. (1988). The party of fear. The American far right from nativism to the militia movement. Chapel Hill: University of North Carolina Press.
Berinsky, A. J. (2012). The birthers are (still) back. YouGov. Retrieved July 1, 2012 from http://today.yougov.com/news/2012/07/11/birthers-are-still-back/.
Bishop, B. (2009). The big sort: Why the clustering of like-minded America is tearing us apart. Boston: Mariner Books.
Boehlert, E. (2012). Why media’s health care reform coverage was even worse than you thought. Huffington Post. Retrieved July 23, 2012 from http://www.huffingtonpost.com/eric-boehlert/why-medias-health-care-re_b_1625065.html.
Brady, D. W., & Kessler, D. P. (2010). Who supports health reform? Political Science & Politics, 43(01), 1–6.
Brewer, P. R. (2001). Value words and lizard brains: Do citizens deliberate about appeals to their core values? Political Psychology, 22(1), 45–64.
Brooks, D. (2012). What republicans think. The New York Times. Retrieved July 23, 2012 from http://www.nytimes.com/2012/06/15/opinion/brooks-what-republicans-think.html.
Campbell, A., Converse, P. E., Miller, W. E., & Stokes, D. E. (1960). The American voter. Chicago: University of Chicago Press.
CBS News. (2009). Steele calls Obama health plan ‘socialism’. CBS News. Retrieved July 23, 2012 from http://www.cbsnews.com/8301-250_162-5174417.html.
Chong, D., & Druckman, J. N. (2007a). A theory of framing and opinion formation in competitive elite environments. Journal of Communication, 57(1), 99–118.
Chong, D., & Druckman, J. N. (2007b). Framing theory. Annual Review of Political Science, 10(1), 103–126.
Citrin, J. (1990). Language politics and American identity. Public Interest, 99, 96–109.
Citrin, J., & Sides, J. (2008). Immigration and the imagined community in Europe and the United States. Political Studies, 56(1), 33–56.
Citrin, J., & Wright, M. (2009). Defining the circle of we: American identity and immigration policy. The Forum, 7(3). Retrieved January 30, 2010 from http://www.bepress.com/forum/vol7/iss3/art6.
CNNMoney.com. (2012). Dimon V. Menendez on ‘un-American’ rules. CNNMoney. Retrieved July 23, 2012 from http://money.cnn.com/video/news/2012/06/13/n-dimon0menedez.cnnmoney.
Crowley, C., & Bash, D. (2012). Boehner: Politics president Obama is running on ‘Almost un-American’. CNN.com. Retrieved July 23, 2012 from http://politicalticker.blogs.cnn.com/2012/01/24/boehner-policies-president-obama-is-running-on-almost-un-american/.
Dateline: USA. (2011). Mark shields: Low taxes are ‘fundamentally un-American’. Townhall.com. Retrieved July 23, 2012 from http://www.theblaze.com.
Druckman, J. N. (2001). The implications of framing effects for citizen competence. Political Behavior, 23(3), 225–256.
Druckman, J. N. (2004). Political preference formation: Competition, deliberation, and the (ir)relevance of framing effects. American Political Science Review, 98(04), 671–686.
FoxNews.com. (2009a). In a tight spot, pelosi calls health care critics ‘un-American’. FoxNews.com. Retrieved July 23, 2012 from http://www.foxnews.com/politics/2009/08/10/tight-spot-pelosi-calls-health-care-critics-american.
FoxNews.com. (2009b). Tom Hanks apologizes for calling mormon supporters of proposition 8 ‘un-American’. Fox News. Retrieved July 23, 2012 from http://www.foxnews.com/story/0,2933,482266,00.html.
Fry, B. N. (2006). Nativism and immigration: Regulating the American dream. New York: LFB Scholarly Publishing.
Gehrke, J. (2012). US filmmakers: Obama DHS ‘draconian, un-American’. Beltway Confidential. Retrieved July 1, 2012 from http://washingtonexaminer.com/article/1221656.
Gelman, A., Lee, D., & Ghitza, Y. (2010). Public opinion on health care reform. The Forum, 8(1). Retrieved July 23, 2012 from http://www.degruyter.com/view/j/for.2010.8.1_20120105083456/for.2010.8.1/for.2010.8.1.1355/for.2010.8.1.1355.xml.
Haidt, J. (2012). The righteous mind: Why good people are divided by politics and religion (1st ed.). New York: Pantheon.
Henry, P. J., & Sears, D. O. (2002). The symbolic racism 2000 scale. Political Psychology, 23(2), 253–283.
Hetherington, M. J., & Weiler, J. D. (2009). Health care, race and political polarization. Washington Post: Short Stack. Retrieved July 1, 2012 from http://voices.washingtonpost.com/shortstack/2009/09/health_care_race_and_political.html.
Higham, J. (1955). Strangers in the land: Patterns of American nativism, 1860–1925 (1st ed.). New Brunswick: Rutgers University Press.
Horowitz, D. (2012). Obama’s un-American nuclear weapons policy. Redstate.com. Retrieved July 1, 2012 from http://www.redstate.com/dhorowitz3/2012/02/17/obamas-un-american-nuclear-weapons-policy/.
Hurwitz, J., & Peffley, M. (2005). Playing the race card in the post-Willie Horton era the impact of racialized code words on support for punitive crime policy. Public Opinion Quarterly, 69(1), 99–112.
Jaffe Ina. (2010). ‘Tea party express’ picks up steam on way to D.C. NPR.org. Retrieved July 23, 2012 from http://www.npr.org/templates/story/story.php?storyId=125294515.
Jones, W. C. (2012). Beebe: Opposition to wind tax break ‘un American’. TheCabin.net—Conway, Arkansas. Retrieved July 23, 2012 from http://thecabin.net/news/local/2012-06-04/beebe-opposition-wind-tax-break-unamerican.
Kaiser Family Foundation. (2012a). Health tracking poll: Exploring the public’s views on the affordable care act (ACA). Retrieved July 23, 2012 from http://www.kff.org/kaiserpolls/health-tracking-poll-interactive.cfm.
Kaiser Family Foundation. (2012b). Kaiser health tracking poll—March 2012. Retrieved July 1, 2012 from http://www.kff.org/kaiserpolls/upload/8285-F.pdf.
Kaiser Family Foundation. (2012c). Kaiser health tracking poll: Early reaction to supreme court decision on the ACA. Retrieved July 1, 2012 from http://www.kff.org/kaiserpolls/upload/8329-C.PDF.
Kam, C. D., & Kinder, D. R. (2012). Ethnocentrism as a short-term force in the 2008 American presidential election. American Journal of Political Science, 56(2), 326–340.
Kinder, D. R., & Sanders, L. M. (1996). Divided by color: Racial politics and democratic ideals. Chicago: University of Chicago Press.
Kinder, D. R., & Sears, D. O. (1981). Prejudice and politics: Symbolic racism versus racial threats to the good life. Journal of Personality and Social Psychology, 40(3), 414–431.
Knoll, B. R. (2013). Assessing the effect of social desirability on nativism attitude responses. Social Science Research, 42(6), 1587–1598.
Knoll, B. R., Redlawsk, D. P., & Sanborn, H. (2011). Framing labels and immigration policy attitudes in the Iowa caucuses: ‘Trying to Out-Tancredo Tancredo’. Political Behavior, 33(3), 433–454.
Knowles, E. D., Lowery, B. S., & Schaumberg, R. L. (2010). Racial prejudice predicts opposition to Obama and his health care reform plan. Journal of Experimental Social Psychology, 46(2), 420–423.
Lewis-Beck, M. S., Norpoth, H., Jacoby, W. G., & Weisberg, H. F. (2008). The American voter revisited. Michigan: University of Michigan Press.
Lillpop, J. (2010). Obama’s un-American tax policy. Toronto: Canada Free Press. Retrieved July 1, 2012 from http://www.canadafreepress.com/index.php/article/27458.
Lynch, J., & Gollust, S. E. (2010). Playing fair: Fairness beliefs and health policy preferences in the United States. Journal of Health Politics, Policy and Law, 35(6), 849–887.
Madrak, S. (2011). Oil company CEO tells senate hearing: It’s ‘Un American’ to take away oil company subsidies. Crooks and Liars. Retrieved July 23, 2012 from http://crooksandliars.com/susie-madrak/oil-company-ceo-tells-senate-hearing.
McAuliff, M., & Kenigsberg, S. (2012). Obamacare is socialism: Reps. Louie Gohmert, Steve king attack. Huffington Post. Retrieved July 23, 2012 from http://www.huffingtonpost.com/2012/03/27/obamacare-socialism-louie-gohmert-steve-king_n_1383973.html.
Mediamatters.org. (2009). On fox & friends, health care reform = socialism. Media Matters for America. Retrieved July 23, 2012 from http://mediamatters.org/blog/2009/07/30/on-fox-amp-friends-health-care-reform-socialism/152672.
Miller, W. E., & Shanks, M. J. (1996). The new American voter. Cambridge: Harvard University Press.
Newby, J. (2011). Former president Bill Clinton: It’s un-American to deny man-made global warming. Examiner.com. Retrieved July 23, 2012 from http://www.examiner.com/article/former-president-bill-clinton-it-s-un-american-to-deny-man-made-global-warming.
Paxton, P., & Mughan, A. (2006). What’s to fear from immigrants? Creating an assimilationist threat scale. Political Psychology, 27(4), 549–568.
Peffley, M., & Hurwitz, J. (2007). Persuasion and resistance: Race and the death penalty in America. American Journal of Political Science, 51(4), 996–1012.
Perea, J. F. (1997). Immigrants out! The new nativism and the anti-immigrant impulse in the United States. New York: New York University Press.
Pew Forum. (2012). Little voter discomfort with Romney’s mormon religion; only about half identify Obama as Christian. Retrieved December 12, 2012 from http://www.pewforum.org/Politics-and-Elections/Little-Voter-Discomfort-with-Romney%E2%80%99s-Mormon-Religion.aspx.
Phillips, K. (2009). Carter’s racism charge sparks war of words. The Caucus. Retrieved July 23, 2012 from http://thecaucus.blogs.nytimes.com/2009/09/16/carters-racism-charge-sparks-war-of-words/.
Preston, J. (2009). Health care debate focuses on legal immigrants. The New York Times. Retrieved July 23, 2012 from http://www.nytimes.com/2009/11/04/health/policy/04immig.html.
Schildkraut, D. J. (2003). American identity and attitudes toward official-english policies. Political Psychology, 24(3), 469–499.
Schrag, P. (2011). Not fit for our society: Immigration and nativism in America (1st ed.). Berkeley: University of California Press.
Schwartz, I. (2012). Palin on contraception flap: ‘An un-American act of our president’. Realclearpolitics.com. Retrieved July 1, 2012 from http://www.realclearpolitics.com/video/2012/02/14/palin_on_contraception_flap_this_is_an_un-american_act_of_our_president.html.
Sears, D. O., & Henry, P. J. (2003). The origins of symbolic racism. Journal of Personality and Social Psychology, 85(2), 259–275.
Sears, D. O., Sidanius, J., & Bobo, L. (2000). Racialized politics: The debate about racism in America (1st ed.). Chicago: University of Chicago Press.
Shea, D. M. (2013). Our tribal nature and the rise of nasty politics. In M. Fiorina (Ed.), Can we talk? The rise of rude, nasty, stubborn politics (pp. 82–98). New York: Pearson.
Skocpol, T., & Williamson, V. (2012). The tea party and the remaking of republican conservatism. Oxford: Oxford University Press.
Taranto, J. (2010). “Is Obama ‘American enough’? Wall Street Journal. Retrieved July 23, 2012 from http://online.wsj.com/article/SB10001424052748704504204575446283852990918.html.
Tarman, C., & Sears, D. O. (2005). The conceptualization and measurement of symbolic racism. The Journal of Politics, 67(03), 731–761.
Tatalovich, R. (1995). Nativism reborn?: The official english language movement and the American states. Lexington: The University Press of Kentucky.
Tesler, M. (2012). The spillover of racialization into health care: How president Obama polarized public opinion by racial attitudes and race. American Journal of Political Science, 56(3), 690–704.
Zeleny, J., & Rutenberg, J. (2009). As race debate grows, Obama steers clear of it. The New York Times. Retrieved July 23, 2012 from http://www.nytimes.com/2009/09/17/us/politics/17obama.html.
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Knoll, B.R., Shewmaker, J. “Simply un-American”: Nativism and Support for Health Care Reform. Polit Behav 37, 87–108 (2015). https://doi.org/10.1007/s11109-013-9263-z
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DOI: https://doi.org/10.1007/s11109-013-9263-z