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Open Access Publications from the University of California

The Supreme Court, Public Opinion, and the Affordable Care Act: The Stability of Partisan Cleavage over Health Care


A fundamental challenge surrounding the role of the United States Supreme Court in American democracy concerns the Court’s countermajoritarian status. Much of the existing research has attempted to “resolve” the countermajoritarian difficulty by examining the link between the Supreme Court and public opinion, particularly whether public opinion can influence the outcome of Court decisions. Interestingly, however, little has been studied about the reverse relationship—that is, whether the Supreme Court can influence public opinion. This paper investigates the Court’s ability to win popular support for its rulings, specifically in the case of NFIB v. Sebelius that ruled on the constitutionality of the 2010 Affordable Care Act. By analyzing various public opinion polls through multivariate analysis, this study finds that the Supreme Court decision has not resulted in an increased public support of the Affordable Care Act but rather bolstered a pre-existing trend of partisan polarization over the issue. With two-sided media coverage of polarized elite opinion of the Court decision, the public too becomes polarized.

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