Obamacare Strengthened Americans' Willingness to Trust One Another - Pacific Standard

Obamacare Strengthened Americans' Willingness to Trust One Another

New research finds a link between implementation of the Affordable Care Act and generalized trust.
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As President Donald Trump tries once again to dismantle Obamacare, new research suggests that program has done more than dramatically increase the number of Americans with health insurance. It has also raised the level of an intangible but important asset: trust.

The research finds that, historically, people who report being in poor health are less trusting of others. However, that link was significantly weakened after the implementation of the Affordable Care Act.

"A substantial and steady decline in generalized trust in the U.S. has been reported since the early 1970s," Swedish researchers Jan Mewes and Giusepe Giordano write in the journal Social Science and Medicine. "Results shown here offer support for the hypothesis that providing comprehensive health care could be an important first step in halting (this) decline."

Trust has been described as the glue that holds a society together. People who trust one another work together better, cooperate more, and feel more connected. Thus the waning of Americans' trust level—which has been linked to rising levels of income inequality—is of great concern.

Surmising that the "quite unique" erosion of generalized trust in the United States could be linked to this country's relatively weak social safety net, Mewes and Giordano decided to test whether implementation of the ACA shifted this trend.

They analyzed data from two panel studies conducted as part of the General Social Survey. The first featured responses by 1,652 participants who were surveyed several times between 2006 and 2010; the second featured responses from 1,187 who were similarly surveyed several times between 2010 and 2014.

They found that, in the years immediately before Obamacare went into effect, "poor self-rated health had a statistically significant and substantial negative impact on generalized trust." But once the program was in place, this association was significantly reduced.

Interestingly, "this change occurred among the general population, rather than (exclusively) among groups that particularly benefitted from the ACA," the researchers write.

In other words, even for people covered by health insurance, the new law provided reassurance that they wouldn't be in dire straits if they lost their job. Perhaps that knowledge helped prop up overall trust levels.

"In societies that lack social security in the form of universal health insurance, worsening health, or even fear of worsening health, can undermine people's optimism and their belief in the future," Mewes, a sociologist at Umea University, said in announcing the findings. "Broadening access to health care really matters, not only in terms of improved health outcomes, but also regarding positively shaping people's attitudes in general."

While the data "can by no means confirm that the ACA was the sole cause" of this positive trend, they strongly suggest it was a major factor. These results provide yet another reason why changing or dismantling the law must be done with the utmost care. 

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