UC Santa Cruz

March 2010 marked the passage of historic health care reform legislation, the Patient Protection and Affordable Care Act (ACA). The partisan showdown that surrounded the introduction of health care reform, through its passage, captivated the public and dominated news coverage. The media undoubtedly influenced public opinion about key areas of contention as well as policymakers’ support or opposition to the ACA. The primary purpose of this study was to investigate how mainstream newspapers framed health care reform from the time that the first version of the ACA was introduced by the Senate Finance Committee through passage of the final legislation. As a highly charged political issue, it is likely that competing frames were emphasized (Chong & Druckman, 2007a; 2007b). A content analysis of 475 articles from seven top–circulating U.S. newspapers was conducted to document the prevalence of competing frames in the following seven domains: (1) the determinants of health; (2) the nature of health care; (3) entitlement to health care; (4) key beneficiaries of health care reform; (5) expense of health care reform; (6) consequences of governmental involvement in health care; and (7) public support for health care reform (limited vs. nearly universal). Support for reform was primarily framed as a health insurance market intervention that would benefit nearly everyone, improve the health care system, and lower costs, whereas, opposition to reform was predominantly described as a costly “government” takeover that would burden individuals and businesses and decrease the quality. Supportive frames about the ACA’s key beneficiaries commonly co-occurred with opposing frames about reform increasing costs. Notably absent were conceptualizations of health care as a human right or public good, even among reform supporters. Future research directions for scholars committed to health care as a matter of social justice are outlined.