Abstract
BackgroundThe Affordable Care Act (ACA), often called “Obamacare,” is a controversial law that has been implemented gradually since its enactment in 2010. Polls have consistently shown that public opinion of the ACA is quite negative.ObjectiveThe aim of our study was to examine the extent to which Twitter data can be used to measure public opinion of the ACA over time.MethodsWe prospectively collected a 10% random sample of daily tweets (approximately 52 million since July 2011) using Twitter’s streaming application programming interface (API) from July 10, 2011 to July 31, 2015. Using a list of key terms and ACA-specific hashtags, we identified tweets about the ACA and examined the overall volume of tweets about the ACA in relation to key ACA events. We applied standard text sentiment analysis to assign each ACA tweet a measure of positivity or negativity and compared overall sentiment from Twitter with results from the Kaiser Family Foundation health tracking poll.ResultsPublic opinion on Twitter (measured via sentiment analysis) was slightly more favorable than public opinion measured by the Kaiser poll (approximately 50% vs 40%, respectively) but trends over time in both favorable and unfavorable views were similar in both sources. The Twitter-based measures of opinion as well as the Kaiser poll changed very little over time: correlation coefficients for favorable and unfavorable public opinion were .43 and .37, respectively. However, we found substantial spikes in the volume of ACA-related tweets in response to key events in the law’s implementation, such as the first open enrollment period in October 2013 and the Supreme Court decision in June 2012.ConclusionsTwitter may be useful for tracking public opinion of health care reform as it appears to be comparable with conventional polling results. Moreover, in contrast with conventional polling, the overall amount of tweets also provides a potential indication of public interest of a particular issue at any point in time.
Highlights
Americans have strong opinions about health care reform
Using regular expressions for our search terms, we identified a tweet as being Affordable Care Act (ACA)-related if it included any of these words or phrases [23]
To determine whether Americans were referring to the ACA as “Obamacare” more or less over time, we show the volume of ACA-related tweets that do and do not contain this term
Summary
Americans have strong opinions about health care reform. Polls of the general public consistently indicate that less than half of Americans support the Affordable Care Act (ACA) [1]. The ACA (or “Obamacare,” as it is more often called) is a federal statute that was enacted under President Barack Obama in 2010. Among the most significant health care reform efforts in US history, the ACA contains a series of provisions that have been implemented since it was signed into law. The ACA remains controversial among policymakers and the general public. The Affordable Care Act (ACA), often called “Obamacare,” is a controversial law that has been implemented gradually since its enactment in 2010. Polls have consistently shown that public opinion of the ACA is quite negative
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