The Effect of Informational and Empathy-Enhancing Interventions on Redistributive Preferences


Informational and empathy-enhancing interventions are effective at increasing support for expanding Medicaid and Medicare benefits in the United States. Photo by Eugene Angoluk.

Informational and empathy-enhancing interventions are effective at increasing support for expanding Medicaid and Medicare benefits in the United States. Photo by Eugene Angoluk.

By Paul Lendway

 

Abstract

Expanding redistributive programs in democracies could improve the living standards for millions of people across the world. Using a national survey experiment consisting of rural white Republicans – a group that tends to oppose expanding redistributive programs – this study shows that informational and empathy-enhancing interventions are effective at increasing support for expanding Medicaid and Medicare benefits in the United States. This suggests that informational and empathy-enhancing interventions may be similarly effective among groups and parties in other countries that also tend to be anti-redistributionist, such as supporters of the Alternative für Deutschland Party, the Swiss People’s Party, and the UK Independence Party.

 

Introduction

Studies around the world have demonstrated the ability of informational and empathy-enhancing interventions to shape attitudes and policy preferences. For example, a 2019 study published in European Union Politics used panel data to assess how media articles about immigration and refugees impacted people’s trust in the European Union (EU).[1] The researchers found that citizens in countries with more coverage about refugees had less trust in the EU. Furthermore, a Swedish study found that exposure to the famous picture of Alan Kurdi, a deceased immigrant child, increased support for more open immigration policies.[2]

But there is a dearth of research on the effect of informational and empathy-enhancing interventions on redistributive preferences. Democracies tend to have one party that is more anti-redistributionist than its competition. Opposition to expanding redistributive programs can take many forms, ranging from the Swiss People’s Party’s opposition to paternity leave, to the UK Independence Party’s push to tighten limitations on National Health Service’s eligibility criteria.[3][4] Could informational and empathy-enhancing interventions change the redistributive preferences of those parties’ supporters?

It would be ideal but very resource-intensive to study the effect of informational and empathy-enhancing interventions on redistributive preferences across an international sample of parties that tend to oppose redistributive policies. A suitable scaled down version would be to assess the effect of informational interventions within a particular country’s context. Therefore, this study focuses on understanding the effect of informational and empathy-enhancing interventions on a particular group: rural white Republicans.

The context of rising inequality in America motivates the importance of understanding rural white Republicans’ anti-redistributionist tendencies, as an increasing share of Americans would benefit from expanding redistributive programs.[5][6] Of course, many rural white Republicans themselves would benefit if programs like Medicare, Medicaid, and the Supplemental Nutrition Assistance Program (SNAP) were expanded. In fact, of all racial groups, the plurality of these programs’ benefits goes to whites.[7][8][9][10] Furthermore, rural communities have the highest share of households receiving SNAP relative to other community types.[11] One may think that rural white Republicans would support expanding redistributive programs such as Medicare, Medicaid, and SNAP. However, rural white Republicans support a party that generally opposes expansion.[12] Are there interventions that can make rural white Republicans more supportive of expanding redistributive government programs? This study is important beyond the case of American politics, because it provides insights into how supporters of anti-redistributionist parties in other democracies may react to similar interventions.

The central theory of this paper is that rural white Republicans will increase their support for expanding redistributive government programs if they receive informational or empathy-enhancing interventions. Using a national survey experiment consisting of rural white Republicans, this paper assesses how a variety of treatments affect preferences toward including hypothetical benefits in three redistributive government programs: SNAP, Medicaid, and Medicare. The treatments include information about program beneficiaries, details about program benefits, and an emotional vignette about a struggling mother whose race is randomly selected to be white, African-American, or unspecified.

This study shows that informational treatments are effective at increasing rural white Republican support for expanding benefits in Medicaid and Medicare, but not SNAP. Providing information about the racial distribution of program beneficiaries increases the share of rural white Republicans who support expanding Medicaid to include all vaccinations recommended by the Centers for Disease Control and Prevention (CDC) by over 5 percentage points. Showing program benefit limitations increases the share of rural white Republicans who support expanding Medicare to include all adult dental benefits by over 10 percentage points.

The emotional vignette treatments are also effective at increasing support for expanding benefits in Medicaid and Medicare. The vignette showing how these programs benefit a struggling white mother causes over a 5 percentage point increase in the share of rural white Republicans who support expanding Medicaid to include all CDC-recommended vaccinations, and expanding Medicare benefits to include all adult dental benefits. Providing a vignette about how these programs benefit a struggling African-American mother increases the share of rural white Republicans who support enhancing government assistance of Medicare premiums by over 10 percentage points. Finally, showing a vignette about how these programs can help a mother of an unspecified race causes over a 10 percentage point increase in the share of rural white Republicans who support expanding Medicare to include all adult dental benefits.

 

Literature Review

Can informational interventions affect redistributive policy preferences? Kuziemko et al. (2015) used a survey experiment to show that information about inequality does little to move redistributive preferences.[13] But McCall et al. (2017) showed that providing information about inequality can change policy preferences.[14] This study extends McCall et al.’s work by assessing the effect of information on redistributive preferences among a specific group that tends to oppose expanding redistributive policies.

Rural white Republicans are an important group to understand in American politics for several reasons. First, a glance at the 2016 or 2020 general election results demonstrates that rural whites are major drivers of the Republican Party’s electoral support.[15] Therefore, to understand the Republican Party’s electoral success would, in part, require understanding the attitudes and preferences of rural white Republicans. Widening inequality in the United States further motivates understanding the attitudes and preferences of this demographic, which plays a key role in providing the electoral support for minimizing the expansion of redistributive government programs.[16]

Considering the extent to which redistributive programs benefit rural white Americans, it is puzzling that rural white Republicans are so loyal to the Republican Party’s generally anti-redistributionist platform. A recent study finds that “SNAP participation nationally was highest among households in rural (16 percent) and small town (15 percent) counties compared to households in metro counties (13 percent).”[17] Another study shows that the vast majority of SNAP benefits goes to whites relative to other racial groups.[18] Studies have provided similar results for other redistributive government programs. For example, more whites receive Medicare than all other racial groups combined.[19] The same holds true for Medicaid.[20] This again raises the question of why so many rural white Republicans support a party that tends to oppose expanding redistributive government programs.

Many Americans have a negative perception of redistributive government program recipients. For instance, Gilens shows that the majority of Americans think that welfare recipients are taking advantage of the system.[21] Furthermore, a study reports that about 40 percent of Americans do not think welfare recipients want to work.[22] This suggests that perhaps rural white Republicans have negative preexisting attitudes toward recipients.

Scholars have documented a low level of political knowledge among Americans.[23][24] But there has not been a rigorous assessment of rural white Republicans’ knowledge of which groups are benefiting from redistributive government programs. Do rural white Republicans underestimate how their communities benefit from redistributive government programs? Cramer’s conception of “rural consciousness” includes the “perception of deprivation relative to other groups—in this case, residents of metropolitan (i.e., urban and suburban) areas.”[25] Her study shows that members of rural communities tend to underestimate the share of government program resources that impact their own communities.

Rural white Republicans may underestimate the extent to which redistributive government programs help whites relative to other groups. Gilens reports that many white Americans think a greater share of African- Americans are on welfare than truly are. Another study finds that Americans miscalculate the percent of African-Americans and Hispanics on welfare.[26]

How knowledgeable are rural white Republicans about the benefit details of redistributive government programs? A recent study reports that many Americans are unaware of the extent to which Medicaid covers children's health insurance.[27] Another study of Americans over the age of 40 finds that “42 percent incorrectly think Medicare pays for ongoing nursing home care and 38 percent think the program covers ongoing care by a home health aide.”[28] Survey research finds that many Americans, particularly Republicans, think that government programs provide excessive aid to program recipients.[29] Such research raises the question of how rural white Republicans’ policy preferences would change if they learned more about the scope of the benefits that characterize redistributive government programs.

Scholars have shown the ability of empathy-enhancing interventions to affect attitudes. For example, a study assessed the effect of “perspective-taking” on Hungarians’ prejudice toward the Roma, who are a financially disadvantaged ethnic minority in Hungary. In this empathy-enhancing intervention, subjects engaged in a game where they imagined themselves as being part of the Roma minority group.[30] The study found that “participation in the game led to a large reduction in anti-Roma sentiment that persisted for at least one month.”

But can empathy-enhancing interventions change policy preferences? Baston et al. experimentally demonstrate that vignettes that increase “empathy for a member of a stigmatized group can improve attitudes toward the group as a whole.”[31] They show that subjects who were given a vignette that promoted empathy for the poor developed more favorable views toward them. More recent work also suggests that empathy can increase support for welfare programs.[32] Thus, increasing rural white Americans’ empathy of redistributive government program recipients via vignettes may increase their policy support of program benefits. Does providing an emotional vignette showing how redistributive government programs can help a struggling rural American lead rural white Republicans to develop greater support for including various program benefits?

It is possible that informational or empathy-enhancing interventions may have no impact on a particular group’s policy preferences. This may be due to partisan motivated reasoning. Partisan motivated reasoning is “when individuals interpret information through the lens of their party commitment.”[33] Therefore, if informational or empathy-enhancing interventions have no effect on a partisan’s attitudes or policy preferences, then such resistance could be rooted in partisan motivated reasoning.

 

Theory

This paper assumes that many rural white Republicans do not have an accurate understanding of the relative geographic and racial allocation of SNAP, Medicare, and Medicaid. Evidence that this assumption holds is displayed in the Results section. Given that this assumption holds, many rural white Republicans may tend to not support redistributive government programs, in part because they are unaware of the extent to which redistributive government programs benefit rural communities and their racial in-group. Therefore, if rural white Republicans learn more about how policies benefit rural white Americans, then they may become more supportive of expanding the benefits included in those policies. As discussed in the literature review, prior research has shown the ability of information to change redistributive preferences.[34] This motivates the following hypothesis:

Hypothesis 1: After learning the extent to which rural white Americans benefit from redistributive government programs, rural white Republicans will have an increase in support for including hypothetical benefits in redistributive government programs.

There is a lack of research surrounding rural white Republicans’ knowledge of government program benefits. Many Americans, particularly Republicans, think that government programs provide excessive aid to program recipients.[35] Therefore, another assumption of this paper is that rural white Republicans tend to view these redistributive government programs as having an excessive set of benefits. Evidence that this assumption holds for many rural white Republicans is displayed in the Results section. Given this assumption, this paper theorizes that learning some of the benefit limitations of redistributive government programs will increase support for including benefits in these programs. The full set of benefit limitation information that’s provided is stated in the appendix.

Hypothesis 2: After learning details about the benefit limitations of redistributive government programs, rural white Republicans will increase their support for including hypothetical benefits in redistributive government programs.

Gilens finds that many Americans view recipients of redistributive government programs negatively. More recent research illustrates that increasing empathy can make perceptions surrounding a negatively viewed group more favorable.[36] Therefore, this paper expects that if rural white Republicans see an emotional vignette that captures how redistributive government programs can help a struggling rural white American, then they will have an increase in support for including benefits in redistributive government programs.

Hypothesis 3: After seeing an emotional vignette about how redistributive government programs can help a struggling rural white American, rural white Republicans will have an increase in support for including benefits in redistributive government programs.

Alesina et al. find that “racial animosity in the US makes redistribution to the poor, who are disproportionately Black, unappealing to many voters.”[37] Furthermore, prior research by Gilens shows that white Americans tend to think that a greater share of non-whites benefit from redistributive government programs than truly do, and that many of those recipients are “lazy.” If rural white Republicans view recipients of redistributive government programs to generally be non-white and undeserving, then perhaps an emotional vignette about a struggling rural African-American will increase their support for including benefits in these programs. This leads to the following hypothesis:

Hypothesis 4: After seeing an emotional vignette about how redistributive government programs can help a struggling rural African-American, rural white Republicans will have an increase in support for including hypothetical benefits in redistributive government programs.

Prior research has illustrated that attempts to build empathy can change attitudes toward “stigmatized” groups.[38][39][40] If rural white Republicans are provided an emotional vignette detailing how redistributive government programs can help a struggling rural American without the recipient’s race specified, then perhaps that is sufficient to increase their support for including benefits in these programs. This leads to the next hypothesis:

Hypothesis 5: After seeing an emotional vignette about how redistributive government programs can help a struggling rural American of an unspecified race, rural white Republicans will have an increase in support for including hypothetical benefits in redistributive government programs.

 

Research Design

This study consisted of an online survey experiment administered on Lucid, an online survey platform commonly used for academic research. The study only includes subjects who self-identified during prescreening to be white and from a rural community. Gender, age, and regional quotas were used, making this an approximately nationally representative sample of 1,200 rural white Americans. There was one control group and there were five treatment groups. Approximately 250 subjects were in each condition. The complete survey is available in the appendix.

First, all subjects were asked standard demographic questions largely drawn from the 2018 Cooperative Congressional Election Survey, including party identification, race, and gender.[41] The analyses in this paper assessed only the Republican respondents. Subjects were also asked a variety of questions surrounding their views of program beneficiaries of SNAP, Medicaid, and Medicare. For each of the programs, subjects were asked which race/ethnicity benefits the most, and whether they agreed that beneficiaries are lazy or abuse the system. Finally, subjects were asked whether they thought these programs provide necessities, luxuries, or an even mix of the two.

Subjects were then randomly assigned to either the control group or one of the five treatment groups. The control group was not given any policy information. The beneficiaries' treatment included information about the geographic distribution of SNAP recipients as well as the racial distribution of SNAP, Medicaid, and Medicare beneficiaries. The data in the beneficiaries' treatment showed that the community type with the highest proportion of households receiving SNAP is rural communities. Furthermore, the beneficiaries' treatment showed that whites make up the greatest proportion of SNAP, Medicaid, and Medicare beneficiaries relative to other racial and ethnic groups.[42][43] The purpose of the beneficiaries' treatment was to show rural white Republicans that on a percentage basis, it is in fact their own racial group that benefits the most from SNAP, Medicaid, and Medicare. Furthermore, the beneficiaries' treatment shows rural white Republicans that their own geographic community type benefits the most from SNAP.

The benefits treatment provided nuanced information about what benefits comprise SNAP, Medicaid, and Medicare. The purpose of this treatment was to test whether demonstrating the scope of program benefits could increase rural white Republicans’ support to expand redistributive government programs. Benefits information was drawn from the Centers for Medicare & Medicaid Services (CMS) and United States Department of Agriculture (USDA) websites.[44][45][46][47][48][49][50]

The last three treatments were emotional vignettes that explained how SNAP, Medicare, and Medicaid could help a struggling single mother living in a rural community. The only difference among these three treatments was whether the mother’s race was stated as white, African-American, or unspecified. Afterwards, all subjects were asked the same outcome questions: whether they agreed or disagreed that certain hypothetical benefits should be included in SNAP, Medicaid, or Medicare.

 

Results

Table 1 shows that many rural white Republicans are unaware that whites benefit the most from these programs relative to other racial and ethnic groups. Only 15 percent of respondents believed that whites benefit the most from SNAP, and only about a quarter of respondents believed that whites benefit the most from Medicaid.

Columns two and three of Table 1 provide evidence that many rural white Republicans tend to harbor negative attitudes toward recipients. Almost half of the respondents somewhat agreed or strongly agreed that SNAP recipients abuse the system. Furthermore, about a third of respondents somewhat agreed or strongly agreed that Medicaid recipients abuse the system.

Table 1.jpg

 Table 2 shows that almost one fifth of respondents either think that these programs provide mostly life luxuries or an even mix of health necessities and life luxuries. This suggests that providing information on benefit limitations may change preferences toward expanding the benefits included in these programs.

Table 2.jpg

Table 3 displays the results from regressing the five dependent variables on the five treatments, controlling for a set of demographic covariates. The program beneficiaries' informational treatment caused a nearly 6 percentage point increase in the share of rural white Republicans who support including all CDC-recommended vaccinations in Medicaid, providing strong support for hypothesis 1. Furthermore, the Medicare dental column provides strong support for hypothesis 2, as the program benefits informational treatment caused over a 10percentage point increase in the share of rural white Republicans who support including all adult dental services in Medicare.

Additionally, Table 3 offers compelling evidence for hypotheses 3-5. Each emotional vignette caused over a 9 percentage point increase in the share of rural white Republicans who support including all adult dental services in Medicare. Furthermore, the white emotional vignette caused over a 6 percentage point increase in the share supporting the inclusion of all CDC-recommended vaccinations in Medicaid. Finally, the African-American vignette caused over a 10 percentage point increase in the share that supports increasing government assistance for Medicare premiums.

Table 3.jpg

Conclusion

This paper has demonstrated that informational and empathy-enhancing interventions increase support for expanding redistributive programs among rural white Republicans. Perhaps such interventions would be effective at increasing support for expanding redistributive preferences among supporters of parties in other countries that tend to resist expanding redistributive government programs, such as supporters of the Alternative für Deutschland Party, the Swiss People’s Party, and the UK Independence Party.[51] Future research could assess the effect of informational and empathy-enhancing interventions on redistributive preferences across this international sample of parties.

Would the changes in policy preferences induced by this paper’s treatments translate to actual changes in voting behavior? Prior research shows that experimentally-induced empathy treatments can affect behavior.[52] This implies that perhaps this paper’s informational and empathy-enhancing interventions could affect voter behavior. But since this study only shows changes in preferences, further research is necessary to assess whether these interventions would lead to actual changes in voting behavior.


About the Author

Paul Lendway is a PhD student in Political Science at Yale University specializing in American political behavior. Prior to Yale, he received a Master’s in Public Administration from the University of Pennsylvania and served as the Office of Undergraduate Studies Business Manager at Virginia Tech. He can be contacted at Paul.Lendway@yale.edu.


Endnotes

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  21. Daniel Lichter and Martha Crowley, “American Attitudes about Poverty and the Poor,” Population Reference Bureau, May 30, 2002, https://www.prb.org/americanattitudesaboutpovertyandthepoor/.

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  24. Katherine Cramer, 2012, “Putting Inequality in its Place: Rural Consciousness and the Power of Perspective.” American Political Science Review 106, no. 3 (August 2012): 517-532, https://www.jstor.org/stable/23275431.

  25. Arthur Delaney and Alissa Scheller, “Who Gets Food Stamps? White People, Mostly,” HuffPost, February 28, 2015, https://www.huffpost.com/entry/food-stamp-demographics.

  26. Providence St. Joseph Press Release, “Providence St. Joseph Study Shows Americans Value Medicaid,” Providence St. Joseph, June 11, 2018, http://www.psjhealth.org/news/2018/06/study-shows-americans-value-medicaid.

  27. Maryann Brodie, Elizabeth Hamel, Mira Norton, “Medicare as Reflected in Public Opinion,” American Society on Aging, 2015, https://www.asaging.org/blog/medicare-reflected-public-opinion.

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  29. Gabor Simonovits, Gabor Kezdi, and Peter Kardos, “Seeing the World Through the Others’ Eye: an Online Intervention Reducing Ethnic Predjudice,” American Political Science Review 112, no. 1 (February 2018): 186-103, https://doi.org/10.1017/S0003055417000478.

  30. Daniel Batson, Marina Polycarpou, Eddie Harmon-Jones, Heidi Imhoff, Erin Mitchener, Lori Bednar, Tricia Klein, and Lori Highberger. “Empathy and Attitudes: Can Feeling for a Member of a Stigmatized Group Improve Feelings Toward the Group?” Journal of Personality and Social Psychology 72, no. 1, (October 2020): 105-118, https://www.doi.org/10.1037/0022-3514.72.1.105.

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  32. Bolsen, Toby, James Druckman, and Fay Lomax Cook, The influence of Partisan Motivated Reasoning on Public Opinion,” Political Behavior 36 (July 2013): 235-262,

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  34. Linley Sanders, “Americans Believe Benefits Fraud is Common for SNAP,” Yougov, September 10, 2019, https://today.yougov.com/topics/politics/articles-reports/2019/09/10/benefits-fraud-common-survey.

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  36. Alberto Alesina, Edward Glaeser, and Bruce Sacerdote. “Why Doesn’t the United States Have a European-Style Welfare State?” Brookings Papers on Economic Activity, Brookings Institute, 2001, https://www.brookings.edu/bpea-articles/why-doesnt-the-united-states-have-a-european-style-welfare-state/.

  37. Petra Gronholm, Claire Henderson, Tanya Deb, and Graham Thornicroft, “Interventions to Reduce Stigma and Discrimination: the State of the Art,” Social Psychiatry and Psychiatric Epidemiology 52, no. 3 (January 2017): 249-258, https://www.doi.org/10.1007/s00127-017-1341-9.

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  39. Stanley Feldman, Leonie Huddy, Julie Wronski, and Patrick Lown, “The Interplay of Empathy and Individualism in Support for Social Welfare Policies, Political Psychology 41, no. 2 (April 2020): 342- 362, https://www.doi.org/10.1111/pops.12620.

  40. Stephen Ansolabehere, Brian Schaffner, and Sam Luks, Cooperative General Election Survey, August 2019, https://doi.org/10.7910/DVN/ZSBZ7K/L6IW51.

  41. “Distribution of Medicare Beneficiaries by Race/ Ethnicity 2008-2018,” Kaiser Family Foundation, https://www.kff.org/medicare/state-indicator/medicare-beneficiaries-by-raceethnicity

  42. “Medicaid Enrollment by Race/ Ethnicity 2013,” Kaiser Family Foundation, https://www.kff.org/medicaid/state-indicator/medicaid-enrollment-by-raceethnicity/

  43. “Acupuncture,” Centers for Medicaid and Medicare Services, 2019, https://www.medicare.gov/coverage/acupuncture.

  44. “Cosmetic Surgery,” Centers for Medicaid and Medicare Services, 2019, https://www.medicare.gov/coverage/cosmetic-surgery.

  45. “Dental Care,” Centers for Medicaid and Medicare Services, 2019, https://www.medicaid.gov/medicaid/benefits/dental-care/index.html.

  46. “Dental Care,” Centers for Medicaid and Medicare Services, 2019, https://www.medicare.gov/coverage/dental-services.

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  51. Claire Adida, Adeline Lo, and Melina Platas, “Perspective Taking Can Promote Short-Term Inclusionary Behavior Toward Syrian Refugees,” Proceedings of the National Academy of Sciences of the United States of America 115, no. 38 (September 2018): 9521-9526. https://doi.org/10.1073/pnas.1804002115.


Appendix

Survey

Demographic Questions

1.  Which of the following best describes your current employment status:

  • Full-time

  • Part-time

  • Temporarily Laid Off

  • Unemployed

  • Retired

  • Permanently Disabled

  • Homemaker

  • Student

  • Other

2.  If employed, which of the following best describes your employment type:

  • Self-employed

  • Employed by the private sector

  • Employed by the public sector

  • Other (please specify)

3.  Are you. . . ?

  • Male

  • Female

4.  In what year were you born?

5.  What racial or ethnic group best describes you?

  • White

  • Black

  • Hispanic

  • Asian

  • Native American

  • Mixed

  • Other

  • Middle Eastern

6.  What is the highest level of education you have completed?

  • No High School

  • High school graduate

  • Some college

  • 2-year

  • 4-year

  • Post-grad

7.  Generally speaking, do you think of yourself as a ... ?

  • Democrat

  • Republican

  • Independent

  • Other

8.  Thinking back over the last year, what was your family’s annual income?

  • Less than $10,000

  • $10,000 - $19,999

  • $20,000 - $29,999

  • $30,000 - $39,999

  • $40,000 - $49,999

  • $50,000 - $59,999

  • $60,000 - $69,999

  • $70,000 - $79,999

  • $80,000 - $99,999

  • $100,000 - $119,999

  • $120,000 - $149,999

  • $150,000 - $199,999

  • $200,000 - $249,999

  • $250,000 - $349,999

  • $350,000 - $499,999

  • $500,000 or more

  • Prefer not to say

9.  Thinking back over the last year, what was your personal annual income?

  • Less than $10,000

  • $10,000 - $19,999

  • $20,000 - $29,999

  • $30,000 - $39,999

  • $40,000 - $49,999

  • $50,000 - $59,999

  • $60,000 - $69,999

  • $70,000 - $79,999

  • $80,000 - $99,999

  • $100,000 - $119,999

  • $120,000 - $149,999

  • $150,000 - $199,999

  • $200,000 - $249,999

  • $250,000 - $349,999

  • $350,000 - $499,999

  • $500,000 or more

  • Prefer not to say

10.    In general, how would you describe your own political viewpoint?

  • Very liberal

  • Liberal

  • Moderate

  • Conservative

  • Very conservative

  • Not Sure

11.    Some people seem to follow what’s going on in government and public affairs most of the time, whether there’s an election going on or not. Others aren’t that interested. Would you say you follow what’s going on in government and public affairs ...

  • Most of the time

  • Some of the time

  • Only now and then

  • Hardly at all

  • I do not know

12.    Which community type best describes the type of community that you live in?

  • City

  • Suburb

  • Town

  • Rural area

  • Other (please specify)

 

Government Program Benefits Knowledge Assessment Questions

1.  Which of the following better characterizes the benefits that are available for those who participate in the government’s SNAP food program:

  • SNAP food program recipients are sent a check each month to spend the money on whatever they want.

  • SNAP food program recipients are given a special card with a designated amount of money put on it each month. They can then use this card to purchase qualified food items as well as plants and seeds to grow their own food.

  • I do not know

2.  Which of the following do you think are generally true for those enrolled in Medicaid? Please click all that apply:

  • Every state Medicaid program offers comprehensive dental care for adults enrolled in Medicaid

  • Medicaid generally covers inpatient hospital services and outpatient hospital services

  • For adults enrolled in Medicaid, every state Medicaid program offers all vaccines recommended for adults by the Center for Disease Control’s Advisory Committee on Immunization Practice (ACIP)

  • I do not know

3.  Which of the following do you think are generally true for those enrolled in Medicare? Please click all that apply:

  • Medicare generally covers in-patient hospital care

  • Medicare generally covers all forms of cosmetic surgery

  • Medicare generally covers acupuncture that is not associated with chronic low back pain

  • Medicare generally covers dental fillings

  • I do not know

4.  Do you think Medicare requires that most beneficiaries pay a monthly bill called a premium?

  • Yes

  • No

  • I do not know

5.  Do you think the SNAP program includes funds to purchase tooth paste or other non food items?

  • Yes

  • No

  • I do not know

6.  Do you think the SNAP program includes funds can be used to purchase alcohol or tobacco?

  • Yes

  • No

  • I do not know

 

Government Program Beneficiary Knowledge Assessment Questions

1.  The Supplemental Nutritional Assistance Program (SNAP), formerly known as food stamps, is a government program that helps many low-income Americans pay for food. Which of the following community types listed below has the highest percent of households receiving SNAP?

  • Metropolitan Areas

  • Small Towns

  • Rural Areas

  • I do not know

2.  Which race/ethnicity has the highest percent of households receiving SNAP?

  • Blacks

  • Whites

  • Hispanics

  • Other (please specify)

  • I do not know

3.  Medicaid is a government program that provides healthcare for many low-income Americans. Which race/ethnicity has the highest Medicaid enrollment?

  • Hispanics

  • Blacks

  • Whites

  • Other (please specify)

  • I do not know

4.  Medicare is a government program that provides healthcare for many senior citizens. Which race/ ethnicity has the highest Medicare enrollment?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know

 

Attitudes and Knowledge Assessment

1.  Which of the following best describes your attitude toward government programs such as SNAP, Medicare, and Medicaid?

  • These programs only provide health necessities

  • These programs mostly provide health necessities

  • These programs provide an even mix of health necessities and life luxuries

  • These programs mostly provide life luxuries

  • These programs only provide life luxuries

  • I do not know

2.  Do you think the SNAP program should include funds to purchase tooth paste or other nonfood items?

  • Yes

  • No

  • I do not know

3.  Do you think the SNAP program should include funds for alcohol?

  • Yes

  • No

  • I do not know

4.  Among those who receive Medicaid, do you think Medicaid should cover all vaccines recommended for adults by the Center for Disease Control’s Advisory Committee on Immunization Practice (ACIP)?

  • Yes

  • No

  • I do not know

5.  Do you think Medicare should cover all dental services, including all dental fillings, for all adults who are eligible for Medicare?

  • Yes

  • No

  • I do not know

6.  Do you think the government should increase spending on Medicare to lower the monthly bill (premium) for Medicare beneficiaries below the poverty line?

  • Yes

  • No

  • I do not know

7.  To what extent do you agree with the following statement: People who receive government programs such as SNAP are lazy.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

8.  To what extent do you agree with the following statement: People who receive government programs such as Medicare are lazy.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

9.  To what extent do you agree with the following statement: People who receive government programs such as Medicaid are lazy.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

10.    To what extent do you agree with the following statement: People who receive SNAP often abuse the SNAP program.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

11.    To what extent do you agree with the following statement: People who receive Medicare often abuse the Medicare program.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

12.    To what extent do you agree with the following statement: People who receive Medicaid often abuse the Medicaid program.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

13.    Which of the following best describes your level of trust in the government to take care of your needs?

  • I strongly trust the government to take care of my needs.

  • I somewhat trust the government to take care of my needs.

  • I do not trust the government to take care of my needs.

14.    Which race/ ethnicity do you think benefits the most from Medicaid?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know

15.    Which race/ ethnicity do you think benefits the most from Medicare?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know

16.    Which community type do you think benefits the most from the SNAP food program?

  • Small Towns

  • Rural Areas

  • Metropolitan Areas

  • I do not know

17.    Which race/ ethnicity do you think benefits the most from the SNAP food program?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know

Treatments

Treatment 1: Beneficiary Facts Treatment:

Below are the results from a recent study on the distribution of the percent of households receiving SNAP by community type. This information comes from an American Community Survey study. As you can see, rural areas have the highest share of households receiving SNAP relative to the other two community types:

Table 1a.jpg

Below are the results from a recent study on the distribution of the percent of households receiving SNAP by race/ ethnicity and the number of households receiving SNAP by race/ ethnicity. As you can see, whites have the highest share of households receiving SNAP relative to other racial/ ethnic groups:

tABLE 2B.jpg

Below are the results from a recent study on Medicaid enrollment by race/ ethnicity. This information comes from the Kaiser Family Foundation. As you can see, whites have the highest share of Medicaid enrollment relative to other racial/ ethnic groups:

Table 3a.jpg

Below are the results from a recent study on the distribution of Medicare enrollment by race/ ethnicity. This information comes from the Kaiser Family Foundation. As you can see, whites have the highest share of Medicare enrollment relative to other racial/ ethnic groups:

Table 4a.jpg

Treatment 2: Policy Facts Treatment:

Here is some general information about the SNAP food program, Medicaid, and Medicare. The Supplemental Nutritional Assistance Program (SNAP), formerly known as food stamps, is a government program that helps many low-income Americans pay for food. According to the United States Department of Agriculture’s website, low-income Americans eligible for the SNAP food program are sent a special card with a designated amount of money put on it each month. At authorized locations, they can then use this card to buy qualified food items as well as seeds used to grow their own food. The SNAP food card may not be used to spend money on tooth paste or other nonfood items. Furthermore, the SNAP food card may not be used to purchase tobacco or alcohol.

Medicaid is a government program that provides healthcare for eligible low-income Americans. Some examples of Medicaid benefits include inpatient hospital services as well as outpatient hospital services. According to the Medicaid.gov website, many state Medicaid programs do not provide comprehensive dental care for adults on Medicaid. Some state Medicaid programs do not provide all of the vaccines for adults recommended by the Center for Disease Control’s Advisory Committee on Immunization Practice (ACIP).

Medicare is a government program that provides healthcare for senior citizens. Some examples of Medicare benefits include services such as inpatient hospitalizations and hospice care. According to the Medicare.gov website, “Medicare usually doesn’t cover cosmetic surgery” except under some exceptions. Medicare typically does not cover dental fillings. In general, Medicare only covers acupuncture for chronic lower back pain. Most Medicare beneficiaries are required to pay a monthly bill (premium) to receive Medicare.

Treatment 3: Emotional Vignette (White)

Kristy is a low-income white mother living in a rural community. Born into poverty, Kristy has only a high school education as her family did not have the money to afford college. Her husband died from a serious medical condition, leaving her on her own to raise their two children. She struggles to make her rent payments and to provide basic needs for her family. The United States government has policies to help people like Kristy. Medicaid is a government program for low income Americans that helps people like Kristy afford basic healthcare. The SNAP food program, formerly known as food stamps, helps people like Kristy afford healthy food. And when Kristy becomes 65 years old, she will be eligible for Medicare, which provides healthcare for senior citizens.

 

Treatment 4: Emotional Vignette (African-American)

Kristy is a low-income African-American mother living in a rural community. Born into poverty, Kristy has only a high school education as her family did not have the money to afford college. Her husband died from a serious medical condition, leaving her on her own to raise their two children. She struggles to make her rent payments and to provide basic needs for her family. The United States government has policies to help people like Kristy. Medicaid is a government program for low income Americans that helps people like Kristy afford basic healthcare. The SNAP food program, formerly known as food stamps, helps people like Kristy afford healthy food. And when Kristy becomes 65 years old, she will be eligible for Medicare, which provides healthcare for senior citizens.

 

Treatment 5: Emotional Vignette (Unspecified Race)

Kristy is a low-income mother living in a rural community. Born into poverty, Kristy has only a high school education as her family did not have the money to afford college. Her husband died from a serious medical condition, leaving her on her own to raise their two children. She struggles to make her rent payments and to provide basic needs for her family. The United States government has policies to help people like Kristy. Medicaid is a government program for low income Americans that helps people like Kristy afford basic healthcare. The SNAP food program, formerly known as food stamps, helps people like Kristy afford healthy food. And when Kristy becomes 65 years old, she will be eligible for Medicare, which provides healthcare for senior citizens.

Dependent Variable Questions

1.  Which of the following best describes your attitude toward government programs such as SNAP, Medicare, and Medicaid?

  • These programs only provide health necessities

  • These programs mostly provide health necessities

  • These programs provide an even mix of health necessities and life luxuries

  • These programs mostly provide life luxuries

  • These programs only provide life luxuries

  • I do not know

2.  Do you think the SNAP program should include funds for tooth paste or other nonfood items?

  • Yes

  • No

  • I do not know

3.  Do you think the SNAP program should include funds for alcohol?

  • Yes

  • No

  • I do not know

4.  Among those who receive Medicaid, do you think Medicaid should cover all vaccines recommended for adults by the Center for Disease Control’s Advisory Committee on Immunization Practice (ACIP)?

  • Yes

  • No

  • I do not know

5.  Do you think Medicare should cover all dental services, including all dental fillings, for all adults who are eligible for Medicare?

  • Yes

  • No

  • I do not know

6.  Do you think the government should increase spending on Medicare to lower the monthly bill (premium) for Medicare beneficiaries below the poverty line?

  • Yes

  • No

  • I do not know

7.  To what extent do you agree with the following statement: People who receive government programs such as SNAP are lazy.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

8.  To what extent do you agree with the following statement: People who receive government programs such as Medicare are lazy.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

9.  To what extent do you agree with the following statement: People who receive government programs such as Medicaid are lazy.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

10.    To what extent do you agree with the following statement: People who receive SNAP often abuse the SNAP program.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

11.    To what extent do you agree with the following statement: People who receive Medicare often abuse the Medicare program.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

12.    To what extent do you agree with the following statement: People who receive Medicaid often abuse the Medicaid program.

  • Strongly Agree

  • Somewhat Agree

  • Indifferent

  • Somewhat Disagree

  • Strongly Disagree

  • I do not know

13.    Which of the following best describes your level of trust in the government to take care of your needs?

  • I strongly trust the government to take care of my needs.

  • I somewhat trust the government to take care of my needs.

  • I do not trust the government to take care of my needs.

  • I do not know

14.    Which race/ ethnicity do you think benefits the most from Medicaid?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know

15.    Which race/ ethnicity do you think benefits the most from Medicare?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know

16.    Which community type do you think benefits the most from the SNAP food program?

  • Small Towns

  • Metro Areas

  • I do not know

17.    Which race/ ethnicity do you think benefits the most from the SNAP food program?

  • Whites

  • Hispanics

  • Blacks

  • Other (please specify)

  • I do not know