Does Racism Drive Opposition to Health Reform?

Even among the most extreme opponents of President Obama's push for health care reform -- those who equate his proposals to Nazi death camps or Soviet gulags -- there's little overtly expressed racism. Aside from the occasional slip by Republican officials in South Carolina, the public debate over expanding coverage to the uninsured has largely ignored Obama's status as the first African-American president.

But implicit racism -- prejudice unacknowledged in public and, in many cases, hidden from conscious awareness -- is a factor in opposition to Obama's health policies. That's the conclusion of a provocative new paper that's one of two research reports on prejudice and the president just published in the Journal of Experimental Social Psychology.

Participants in a yearlong study who scored low on implicit prejudice found the proposed health care plan equally appealing whether it was attributed to Bill Clinton or President Obama. However, those who scored high in implicit prejudice supported the plan when it was linked to Clinton, but opposed it when linked to Obama.

A team of scholars led by psychologist Eric Knowles of the University of California, Irvine recruited 285 Americans (236 white, 43 Asians, six Latinos) from a Stanford University database. (Blacks were deliberately excluded, since the issue at hand was how non-blacks feel about blacks, and whether those feelings affect voting decisions and political opinions.) In late October 2008, the participants took tests designed to measure both explicit and implicit racial prejudice.

To gauge levels of implicit racism, they performed the Go/No-go Association Task, a variation on the Implicit Association Test. Knowles describes it this way:

"The Go/No-go Association Task has individuals categorize words -- specifically, stereotypically African-American names and words that carry pleasant or unpleasant meaning -- into the categories ‘black' and ‘bad' or ‘black' and ‘good.' Some participants have great difficulty categorizing black names and pleasant words at the same time, while finding it easy to simultaneously categorize black names and unpleasant words. These participants are deemed to mentally associate the black category and bad things."

In a second assessment the following week, participants were asked about their attitudes toward then-candidate Barack Obama. Three weeks later, they were asked who they voted for in the presidential election. Finally, in early October 2009, 230 of the original participants were asked about the current health care debate.

Half of them were asked about their support or opposition to the Democratic health care proposals, and asked to rate six potential concerns about the policy. The results: "Subjects who showed no bias against blacks (in the original test) were about evenly split on Obama's health care plan, with 48 percent opposed to the plan and 52 percent supporting it," Knowles reports. "However, subjects with an anti-black bias were opposed to the Obama plan by almost two-to-one, with 66 percent opposed and 34 percent supporting it."

The remaining 130 participants "were randomly assigned to read a description of health care reform framed either as being President Obama's plan or Bill Clinton's 1993 plan. The description was identical across conditions and described elements common to both plans. After reading the description, participants rated their attitude toward the plan."

The results were quite striking.

"When the health care reform plan was framed as former President Clinton's idea, a majority of both high- and low-prejudice subjects (65 percent and 66 percent) supported the plan," Knowles said. "However, when the plan was framed as Obama's idea, support among biased subjects fell to 41 percent, while support among low-bias subjects remaining essentially unchanged (70 percent)."