Can Public Policy Influence Public Opinion? Studying Feedback Effects and Elite Influence Using the Affordable Care Act

Political elites often claim that the passage of new public programs will shift the political debate by influencing public opinion. These expectations also motivate elites to engage in messaging that they believe will further shape public opinion toward these new programs. In Stable Condition, Daniel J. Hopkins subjects these beliefs-and their social science analogues of policy feedback and opinion leadership-to rigorous and exhaustive scrutiny in a comprehensive assessment of how the Affordable Care Act (ACA) affected public opinion. Contrary to much of the elite and scholarly consensus, Hopkins finds little or no effect of the ACA or its attendant messaging wars on public opinion. In this essay, I highlight what I see as some of the key contributions of the book to the literature on policy feedbacks. One of these contributions is the strength of the empirical analysis, which convinces me that the author's conclusions about the ACA's limited effects are correct. In the latter part of the review, however, I question how much we can learn about feedback effects in general from this particular case, given the strategic considerations that informed the ACA's passage. Last, I re-evaluate the book's conclusions of opinion stability given longer-term trends in both policy and opinion.