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Health Care Access & Coverage
Who Wants Government Health Care and Unemployment Programs to Expand?
People Who Felt Most at Risk from COVID-19 Tend to Favor Expansions—Regardless of Their Political Attitudes
For many Americans, the COVID-19 pandemic was both frightening and financially devastating. Along with unrelenting worries about getting severely ill or dying from the virus—or inadvertently infecting others—millions of people lost their jobs and struggled to pay their rent, mortgage, and credit card bills.
The federal government responded by providing vaccines along with more affordable and accessible health care, increased food and housing assistance, money for families with children, funds for small businesses and hospitals, and higher unemployment payments.
How did individual experiences with COVID-19 affect Americans’ feelings about the federal safety net? Senior LDI Fellow Alex Rees-Jones wanted to find out. “The ideal use of safety-net policy is to provide us protections against unpredictable personal or economic shocks that are outside of our control,” Rees-Jones said. “Workers losing their jobs during the initial COVID-19 shut-downs are as perfect an example of that as I’ve ever seen.”
In his study published recently in the Journal of Economic Behavior & Organization, Rees-Jones and colleagues showed that Americans who felt more severely impacted in the early days of the COVID-19 pandemic—either objectively or subjectively—felt more positive about expansions to government health care and unemployment insurance.
Sampling a Wide Swath of America
The researchers used datasets from a variety of surveys deployed over two years by the Understanding America Study and merged them with data from their own survey, administered early in the pandemic, on support for safety-net policies, and with county-level data on COVID-19, and unemployment data.
After controlling for demographics and political ideology, they found that Americans who experienced a 1-standard-deviation increase in county-level impact from COVID-19 had an increased probability of supporting unemployment insurance expansion (4.1 percentage point increase) and government-provided health care expansion (3.6 percentage point increase). Americans who experienced a 1-standard-deviation increase in subjective risk assessment were also more likely to support unemployment insurance expansion (2.0 percentage point increase) and government-provided health care expansion (2.1 percentage point increase).
“An effect of this size was kind of surprising,” Rees-Jones said. “This suggests that experiences people had in the early days of COVID-19 are quantitatively quite influential in their attitudes toward safety nets, with swings in attitudes comparable to what people experienced around the great recession. Changes of this size can influence the types of policies we put in place going forward and could conceivably influence elections.”
Potential Impact of Changing Preferences for Safety-net Reforms
As the researchers noted in their paper, the influence of the COVID-19 safety net on policy preferences may have already affected American politics by “contributing to the ﬁnding that county-level infection and death counts predicted a loss of vote-share for incumbent President Trump in the 2020 presidential election.”
These changes in policy preferences may continue to affect Americans long after the pandemic subsides. The pandemic tested our safety-net system and raised awareness of these policies among people who rarely thought about them. As Rees-Jones said, “We all got a chance to think about what we think is working well, what we think is working poorly, and what we wish would be designed differently during the next crisis. I think the experiences we shared as a society during this episode will be a focal part of how we think about these policies for quite some time to come.”
The study, “Experience of the COVID-19 Pandemic and Support for Safety-Net Expansion,” was published in the Journal of Economic Behavior & Organization in August 2022. Authors include Alex Rees-Jones, John D’Attoma, Amedeo Piolatto, and Luca Salvadori.
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