Abstract

The June 2012 Supreme Court decision on Medicaid expansion provides insight into how physicians and the general public engaged with the political and policy-making process. This study assesses the making of public statements on Medicaid policy, through analyzing letters to the editor published in one hundred newspapers across the United States. A total of 2,792 individual letters to the editor were coded for their stance, use of evidence, use of personal experience, and framing of the Medicaid expansion. Both the general public and physicians expressed support for expansion in their letters, but physicians were more likely to emphasize the role of Medicaid expansion at improving the quality of care and saving lives. Additionally, physicians were more likely to cite evidence and personal experiences while framing their position on Medicaid expansion. There is no evidence of a shift in stance on Medicaid expansion after the election of Donald Trump, and Medicaid policy changes made by the new administration highlight the importance of the public engaging in the political and policy-making process of Medicaid.