Policy Effect of ACA/Medicaid Spending in Kentucky

Samuel Mitchell working at desk




Associate Professor of Political Science

Project Summary

In my project, I worked with a team of research assistants and Prof. Dan Hopkins’ to determine possible changes in voting behavior and political perspectives associated with policy interaction. Over the summer, we specifically focused on the Medicaid expansion of the Affordable Care Act. Passed in 2010, the Supreme Court created a unique natural experiment with the ACA because it allowed states to opt out of the Medicaid expansion. This allowed our research to focus in particular on special cases like Kentucky, where a large number of traditionally conservative voters had direct impact with law. Additionally, the case of Kentucky contains many opportunities for further research into framing around health policy issues, as Kentucky’s Obamacare exchanges are branded to avoid association with the federal social program.


We collected national polling data from the Kaiser Family Foundation, a critical health policy polling group, and paired it with more localized data on voting patterns and types of insurance in order to track potential policy effects. I spent a lot of time writing code in R and Python to help clean the data and merge the years and years of polls into a usable dataset.


This project is part of a broader scope of inquiry by Prof. Hopkins into policy interactions and behavior. This line of research is at the intersection of psychology, behavioral economics, and numerous other social science subdisciplines. It has crucial real-world applications; it is possible that future policymakers will be interested in looking at the way that social programs like the ACA affect behavior when they design future programs. They’ll also be interested to look at questions around the dispersed nature of Medicaid recipients and their relatively small numbers when they think about comparing this program to more popular ones like Medicare and Social Security.