Date of Award

Summer 7-1-2022

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Political Science


Gadarian, Shana K.


Affordable Care Act (ACA), Participation, Policy feedback, Political behavior, Voting

Subject Categories

Political Science | Public Affairs, Public Policy and Public Administration | Social and Behavioral Sciences


What happens when a policy with millions of beneficiaries is threatened? The Affordable Care Act (ACA) has been under attack since before it was signed into law, culminating in its only legislative challenge under the Trump administration in 2017. While we know that policies like the ACA produce policy feedbacks that affect policymaking and shape policy attitudes, less is known about behavioral feedback effects that serve to mobilize beneficiaries to protect and maintain their health insurance benefits in the face of ACA threat. This dissertation leverages a 3-paper design to evaluate under what conditions threat facilitates behavioral change, and how to identify beneficiaries for purposes of political mobilization. The first paper relies on survey data to examine perceptions of threat among self-reported ACA beneficiaries and how this affects political participation, while the third paper examines how threat produces behavioral change using an original survey experiment comparing threat messaging to opportunity messaging around a fictitious ACA amendment. While findings across these two studies are mixed, results generally suggests that ACA threat leads individuals, particularly those who benefit from the policy, to increase their political participation to protect against perceived policy threat. The second paper evaluates challenges with surveys that rely on self-reported policy benefits, and examines what factors affect misreporting of benefits – offering one solution to predict ACA beneficiaries using known demographic predictors of ACA benefit. Together, the findings of the three papers, while supportive of threat as a key motivator of protective political behaviors, draw attention to the limitations of survey data and our reliance of self-reports in studies of policy change and political behavior.


Open Access