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The public debate over health care reform in 2009 was carried out partly through issue advertisements aired online and on television. Did these advertisements alter the course of the debate over health care reform? While millions of dollars are spent each year on issue ads, little is known about their effects. Results from a naturalistic online experiment on the effects of issue ads suggest that they can influence the perceived importance of an issue and perceptions of politicians associated with the featured policy while influencing policy support only among those low in political awareness.