Journal of Communication ISSN 0021-9916

ORIGINAL ARTICLE

Effects of Unresolved Factual Disputes in the News on Epistemic Political Efcacy

Raymond J. Pingree
School of Communication, The Ohio State University, 3016 Derby Hall, 154 N Oval Mall, Columbus, OH 43210, USA

This experiment tests effects of passive, neutral reporting of contradictory factual claims on audiences. Exposure to such reporting is found to affect a new self-efcacy construct developed in this study called epistemic political efcacy (EPE), which taps condence in ones own ability to determine truth in politics. Measurement of EPE is found to be reliable and valid, and effects of neutral reporting on it are found to be conditional on prior interest in the issues under dispute. Implications of this effect and of EPE are discussed. Self-efcacy theory (Bandura, 1982) suggests these short-term effects may accumulate over time. EPE may affect outcomes related to political understanding, opinion formation, and information seeking. doi:10.1111/j.1460-2466.2010.01525.x

Many have criticized modern journalism for playing too passive a role in factual disputes (Cunningham, 2003; Durham, 1998; Jamieson & Waldman, 2003; Rosen, 1993; Streckfuss, 1990). As a result of a number of factors, but most importantly newsroom cost-cutting, faster news cycles, and fear of going out on a limb, mainstream American journalism has become drastically more passive over the past few decades (Anderson, 2004; Jamieson & Waldman, 2003; McChesney, 1999, 2004; Patterson, 2000; Plasser, 2005). Although the proliferation of news outlets creates the appearance that journalism is thriving, fewer reporter-hours are devoted to each story, leaving less time for journalists to do their homework (Jamieson & Waldman, 2003). As a result, journalists often resort to he said/she said reporting, in which even when two sides make directly contradictory claims about a veriable factual question, the reporter leaves it as an exercise for the reader to do the additional homework necessary to resolve the dispute (e.g., reading the text of a bill, checking transcripts or recordings of a speech, and questioning an expert or an eyewitness). One alarming possible consequence of such reporting is a trend toward increased levels of factual disagreement across party lines, with factual belief differences

Corresponding author: Raymond J. Pingree; e-mail: pingree.2@osu.edu

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perhaps even replacing inherently subjective value differences as the primary basis of partisan polarization (Shapiro & Bloch-Elkon, 2008). Shapiro and Bloch-Elkon point out that this has consequences for the health of a democracy because it indicates incorrect factual beliefs among partisans on one side or the other. However, effects of passive journalism may not be limited to the partisan faithful or to specic incorrect beliefs. It would be perfectly understandable for someone caught between two rapidly diverging partisan versions of reality to disengage from politics out of a profound sense of inefcacy about what to believe. This article develops and validates a measure of this feeling of inefcacy about political truth, while also testing effects of passive versus active journalism on it. The self-efcacy construct developed here, epistemic political efcacy (EPE), is a form of condence in ones own ability to determine the truth about factual aspects of politics. Although political efcacy is condence in ones ability to affect politics, EPE is a form of condence in ones ability to understand it. As such, this construct may be a missing communication counterpart to one of the most widely useful constructs in political science, promising to improve our understanding of information seeking, opinion formation, political learning, and other understanding-oriented citizen behaviors and cognitions. Along with this novel dependent variable, also thought to be of potential utility to communication researchers is the novel independent variable in this study, which is whether a news story actively adjudicates factual disputes or passively reports a he said/she said story. There has been almost no research on how this affects audiences. Despite urgent alarms about the decline or even the death of journalism as an effective watchdog over government and more generally as a guardian of honesty and accuracy in our national discussion (e.g., Nichols & McChesney, 2009), research has told us little about how the resulting changes in the content of news stories actually affects audiences. This study aims to pave the way for more research into these effects, demonstrating how journalistic adjudication can be a tractable experimental manipulation by isolating it from balance, story length, and the number of facts presented. Past work is mostly theoretical or content analytic and tends not to even theorize possible psychological consequences for audience members in any depth, framing the problem instead as a failure to keep political elites honest. A partial exception comes from research on science and health reporting, in which many have pointed out how balanced journalism can allow corporations to manufacture uncertainty about questions such as the health consequences of smoking or the link between human activity and climate change (for a review see Michaels & Monforton, 2005). This research has focused on specic uncertainty about the particular questions under dispute, and the concept of manufacturing uncertainty is usually thought of as limited to realms of expert knowledge. This study extends this concept in two key directions: into the realm of everyday political facts that ordinary journalists should be able to check for themselves and beyond specic uncertainty about any particular facts under dispute to a broader, generalized sense of political uncertainty (epistemic political inefcacy).
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Journalistic adjudication

According to many critics, the crucial test of journalism is when sources make contradictory factual claims; in these moments, passive journalists stop at reporting the opposing claims when they should, as Jamieson and Waldman (2003) put it, adjudicate factual disputes. This adjudication is not a radical or novel proposal foreign to reporters habits; it comes down to the extent to which they do their homework by checking facts, looking for additional sources, and doing their own analysis. There is no limit to the amount of such homework that can be done on any given story, and there is no guarantee that it will resolve important factual disputes between sources. Ideally, journalists would decide how much adjudication a dispute merits based on a careful and open-minded assessment of its importance and resolvability. However, there are of course limits to journalists time to work on any given story. Particularly in forms of journalism in which time is very limited such as 24-hour cable news and also in general as a consequence of modern journalisms understaffed newsrooms and fast news cycles (Anderson, 2004; Bantz, McCorkle, & Baade, 1980; Fishman, 1988; Jamieson & Waldman, 2003), there is a large and growing gap between actual and ideal levels of adjudication. Furthermore, for various other nonideal reasons, some journalists may shy away from adjudication even when it requires little effort. One such reason is that there is an alternative denition of objectivity rooted in a very different view of the role of journalism in society (Streckfuss, 1990). In this view, objectivity is equated with neutrality. The ideal of neutrality means the journalist should never take a side in any dispute. This often contradicts the original denition of journalistic objectivity, which dictates that the journalist should always take a side in a factual dispute when an overwhelming weight of evidence supports that side, regardless of whether it is the side the journalist was predisposed to favor (Streckfuss, 1990). The two ideals can result in identical reporting, but only on disputes that are either inherently subjective or for whatever reason difcult to achieve a reasonable threshold of certainty about. The test of which ideal a journalist is striving for is when easily available evidence strongly supports one side of the dispute and not the other. In such cases, an individual journalists own belief in the ideal of neutrality is only one of several factors that may cause a journalist to remain neutral. A journalist might also fear that the audience, editors, or others within the news organization would judge objectivity based on the balance of the end product, not the apparent fairness and depth of the news gathering process that produced it. In other words, the choice between denitions and practices of objectivity may often be a strategic one to minimize risk to the reporter or news organization (Tuchman, 1972). This is not to say that journalists never adjudicate factual disputes or that all disputes could be resolved cleanly by journalistic adjudication. Some journalists do make the effort some of the time, and some disputes are either inherently subjective or complex enough that it would be unreasonable to expect journalistic resolution. However, in cases when these legitimate reasons for a lack of adjudication do not apply, the factors discussed above tend to prevent journalists from seeking or
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including adjudicating content. Taken together, these factors provide sufcient reason to suspect that modern journalism supplies lower than ideal levels of adjudication. Although the critique here rests on a comparison of current journalism to an ideal and not on comparisons to any past era, others have argued that recent decades have seen a precipitous decline in various resources and norms that allow and encourage individual reporters to adjudicate factual disputes and more generally to produce high-quality journalism (e.g., Anderson, 2004; McChesney, 1999, 2004; Patterson, 2000; Plasser, 2005).
Adjudication and indexing

A closely related critique of modern journalism comes from the indexing hypothesis, which posits that journalism indexes the range of views it presents on the range of views that exist within mainstream government debate (Bennett, 1990). As a result, if opposing elites do not speak out against a policy, reporting on it tends to be one sided, failing to represent a broader range of stable and reasonable public opinion or even expert opinion. Like the critique of neutrality, indexing is at heart a critique of journalistic norms of balanced reporting. Both critiques are related to balance-oriented journalism being ultimately too elite-driven and lacking its own voice in public debate. Indexing makes for imbalanced news when there is a lack of balance in elite discourse. In contrast, insufcient adjudication is a way in which journalism can function poorly even when it produces balanced news stories. The normative standard Bennett advocates is applicable to coverage of the inherently subjective side of politics, but to treat it as a broad normative theory of the ideal role of the press in a democracy would implicitly assert that this realm of opinion is the entirety of politics, taking the radically relativist epistemic position that there are no political facts, and that therefore the only politically neutral normative standard is the breadth of the range of opinions presented. The two critiques are best seen as complementary. Neither really aims for nor achieves a complete normative framework for the evaluation of all journalism. Just as Bennetts (1990) theory only explains the ideal role of journalism with regard to covering the subjective side of politics, the critique motivating this study is limited to coverage of its factual aspects.
Epistemic political efcacy and related concepts

This study examines the question of whether adjudication affects audience members EPE, which is condence in ones own ability to determine the truth about factual political disputes. Note that this conceptualization does not require accepting any extreme epistemic claims about absolute truth, but it does require rejecting the opposite, relativist extreme that all knowledge is equally uncertain. In the above denition, determine the truth is meant as plain English for achieve a reasonable threshold of certainty. This conceptualization also does not assume that all political questions are entirely objective. Of course, there are important subjective aspects to nearly all political issues. However, a glance at almost any policy news story is enough to demonstrate the absurdity of the claim that politics is entirely subjective. Choosing
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among government policies is simply not like choosing among avors of ice cream. Policy questions quite frequently center on facts, and political disputes can and often do hinge on these facts, not only on subjective matters. The focus here is on these factual aspects of political issues. Therefore, in more precise terms, epistemic political efcacy is ones condence in ones own ability to achieve a reasonable threshold of certainty about the factual aspects of politics. In contrast to political efcacy, which is a form of condence related to political participation, epistemic political efcacy is primarily related to information seeking and opinion formation. This section will distinguish EPE from related concepts including self-efcacy, political efcacy, media trust, and need for closure.
Self-efcacy

The concept of political efcacy developed separately from self-efcacy theory but can and should be grounded in it. Self-efcacy theory posits that the motivation to perform any task operates in combination with an efcacy construct specic to that task (Bandura, 1982; Gist & Mitchell, 1992). In other words, people do not just try to do what they want to do but what they want to do that they also believe they can succeed at. Self-efcacy should not be measured as a general construct unrelated to a particular type of task because such a construct would be indistinguishable from selfesteem (Brockner, 1988). If one can distinguish two types of tasks that are affected by two distinct types of motivation, they can also have two distinct self-efcacy constructs (Brockner, 1988; Gist & Mitchell, 1992). In the case of political efcacy, the behaviors and motivations associated with political action are distinct (at least conceptually) from those associated with political opinion formation and information seeking, and therefore, political efcacy may have a previously unmeasured epistemic counterpart. Self-efcacy theory is also useful for understanding how EPE is constructed over time. Like any efcacy construct, the primary determinant is enactive mastery, which is an accumulation of personal successes or failures at the task, with greater weight given to more recent ones (Bandura, 1982). By making it easier for the reader to decide the truth of particular claims, journalistic adjudication may affect subsequent levels of EPE, both in the short term via greater weight of recent experiences and in the long term by accumulation of condence.
Political efcacy

Political efcacy refers to a feeling of condence in ones ability to participate effectively in the democratic process (Easton & Dennis, 1967; Niemi, Craig, & Mattei, 1991; Morrell, 2003). In predicting participation, it has been useful to distinguish between two forms of political efcacy: internal and external. The best combination for participation is high internal efcacy, meaning high condence in ones own effectiveness at political participation, combined with low external efcacy, meaning a perception that the system is generally unresponsive to citizen participation (Craig, 1979). Although political efcacy is conceptualized as related to political participation and is most often studied in the context of such outcomes, its measures almost always include items with a strong epistemic dimension (e.g., I feel I have a pretty good
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understanding of politics). Improving our ability to empirically distinguish between condence in an ability to affect politics, and condence in an ability to understand it seems particularly applicable to research focused on communication, information seeking, or opinion formation (e.g., Gastil, Black, Deess, & Leighter, 2008; Kenski & Stroud, 2006; Lee, 2006; Morrell, 2005; Pinkleton & Austin, 2001; Pinkleton, Austin, & Fortman, 1998; Shah & Scheufele, 2006; Wells & Dudash, 2007). Although the partly epistemic items in standard internal efcacy scales of course factor well together with the other internal efcacy items, some recent research has attempted to reconceptualize this subset of items on face validity grounds as political information efcacy (Kaid, McKinney, & Tedesco, 2007; Kaid, Postelnicu, Landreville, Yun, & LeGrange, 2007; Sweetser & Kaid, 2008). It remains to be seen whether measures of this construct can be developed that are clearly distinct from either internal efcacy or self-reported political knowledge. In any case, conceptually, political information efcacy is clearly distinct from EPE in that it is condence in the sufciency of the political information one already has for voting and other participation, instead of condence in an ability to evaluate the accuracy of political claims. As such, political information efcacy seems more theoretically relevant for the same participatory outcomes as internal political efcacy and less so for the communication, opinion-formation, and information-seeking outcomes that EPE aims to shed light on.
Media trust

EPE is also conceptually related to media trust. However, this relationship may be complex. Although high trust in media may make some have higher EPE because trusted media is helpful for determining truth, low trust in media may be related to habits of independent verication, which produce very high EPE. Even with this latter point aside, distrust in media is not the only possible source of low EPEfor instance, one might think that the media does a good job but that the problem is with the inherent complexity of political issues or with the clever dishonesty of politicians.
Need for closure

Kruglanski (1989) identies the need for closure as the desire to arrive at a conclusion to avoid uncertainty and contains two relevant subdimensions: a dislike of ambiguity and close-mindedness. Certain individuals, motivated by ambiguity reduction, have a particularly strong desire to make decisions to achieve closure about events regardless of whether they have all the necessary facts. Although it is conceivable that such individuals would feel higher EPE, individuals can have high epistemic condence without necessarily possessing a high need for closure. As the need for closure and its subdimensions are epistemic motivations, they are conceptually distinct from any epistemic efcacy construct and particularly from EPE.
The pilot study

A study, which will hereafter be referred to as the pilot study, found that for those with high prior interest in the issues involved in the factual disputes, adjudication increased
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EPE (Pingree, Brossard, & McLeod, 2006). However, the same study also found the opposite effect for those with low prior interest. For these readers, adjudication actually reduced EPE, instead of increasing it to a lesser extent as originally expected. This may have been an artifact of this studys balanced adjudication in which two sides dispute two different factual matters and each side is contradicted on one of the disputes. A story in which both sides are shown to be dishonest may frustrate low-interest readers who seek a cue about which side to trust. This study aims to address this and other limitations of the pilot study, such as the fact that the nonadjudication condition was a shorter story, and therefore adjudication was not strictly isolated from length or the number of facts presented. Apart from these limitations of the experimental design, the pilot study was also not entirely satisfactory in its measurement of EPE in two ways. First, EPE was not distinguished sufciently from existing political efcacy constructs. External political efcacy was not measured, and a factor analysis failed to separate internal political efcacy measures from EPE measures. A second validity concern is whether EPE items really tap condence in open-minded efforts to discover the truth, as opposed to condence derived from a closed-minded belief that one already knows the truth. Constructs such as dogmatism and closed-mindedness were not measured, leaving open the possibility that EPE may simply be a proxy for those constructs, largely reversing its normative implications.
Possible outcomes of epistemic political efcacy

There are several possible serious consequences of pervasive low levels of citizen EPE for the health of a democracy. Four of these will be discussed here to provide motivation for the present study and suggest directions for future research into the consequences of low levels of EPE.
Citizen competence and information seeking

Citizen competence has been a major theme of recent research in political science, with many lamenting low levels of attention to and knowledge about politics (e.g., Bennett, 2003; Delli Carpini & Keeter, 1996; Kuklinski & Quirk, 2001). Theoretical work on the roots of this problem typically relies on a model positing three ingredients for learning: ability, opportunity (information exposure or availability), and most crucially, interest (Luskin, 1990). Political interest is crucial in this explanation because it is thought to lead to information seeking, attention, and reection, among other behaviors and cognitions that lead to learning. But because interest is also difcult to inuence, this perspective seems to offer little hope for interventions to improve citizen competence among the uninterested (e.g., Delli Carpini, 2000). However, since political interest is a motivational construct, according to self-efcacy theory, it affects behavior in combination with a related efcacy construct. Low levels of EPE may help explain why some citizens who are interested in political issues nevertheless choose to remain uninformed, potentially offering an overlooked and tractable approach for interventions to improve citizen competence. Furthermore,
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because formal education may increase EPE (perhaps via a more general, nonpolitical epistemic efcacy construct that should be developed in future work), EPE may also offer a missing link in explaining the importance of formal education above and beyond its more obvious relationships to knowledge and cognitive ability (e.g., Dee, 2004; Hillygus, 2005; Jerit, Barabas, & Bolsen, 2006).
Stealth democracy beliefs

Another response to the same problem of low citizen competence is to argue that citizens choose not to become competent because they want stealth democracy (Hibbing & Theiss-Morse, 2002). Specically, as the argument goes, they want experts to run government, instead of politicians or the people. Hibbing and TheissMorse argue that stealth democracy is what the people want, implying that it is undemocratic to give them anything else. They effectively assert such beliefs are xed, true preferences. However, these responses could also be due to frustration with politics as it currently exists (or as it is currently reported). Specically, low levels of EPE may make people more likely to say they agree with stealth democracy belief measures.
Openness to reason

Openness to reason is a willingness to change ones mind in the face of a good argument against a prior political belief. Openness to reason is a crucial citizen quality in theories of deliberative democracy (Delli Carpini, Cook, & Jacobs, 2004) and is also a central reason deliberative democracy is often seen as Utopian by those who see such open-mindedness as rare in politics. This critique assumes that being closed against reasons that counter ones political views is a stable trait or even a universal fact of human nature. However, it may be at least in part a function of EPE. Without condence that reasoning about politics might help one approach truth, there is less incentive to engage open-mindedly with the reasoning of others.
Acceptance of dishonesty

Fourth and nal is an acceptance of dishonesty. Low levels of EPE may not just make people tune out of politics, but may make them tune in in ways that disregard truth, such as a willingness to accept dishonesty by ones own side in a political dispute. Low levels of EPE might lead to this simply because when truth seems harder to determine, dishonesty may lose weight as a factor in ones overall assessment of a politician due to increased uncertainty about whether he or she is being dishonest in any given case. In an extreme manifestation of low EPE as a belief that there is no such thing as a political fact, the entire concept of political dishonesty becomes meaningless, making dishonesty by political elites entirely acceptable.
Hypotheses

First, as discussed above, a central goal of this study is to further develop and validate the EPE scale. As such, rst are a set of hypotheses about EPEs expected correlations
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with the conceptually related orientations discussed above. First, because it is a form of political efcacy, EPE is expected to be positively correlated to both other forms of political efcacy. And because mediated information is often important for resolving factual political claims, media trust is also expected to be positively correlated with EPE.
H1: EPE will be positively related to (a) internal political efcacy, (b) external political efcacy, and (c) media trust.

As discussed above, a competing interpretation of any measure of EPE may be that it taps a form of close-mindedness or dogmatism. It is important to test this because it implies opposite normative implications to those intended by the conceptualization of EPE outlined above, indicating a form of condence resulting from prejudgment of truth instead of condence in an ability to open-mindedly determine the truth.
H2: EPE will be positively related to (a) close mindedness and (b) dogmatism.

Regardless of EPEs zero-order relationships with its related orientations as hypothesized above, the crucial test of its utility is whether it adds any explanatory power above and beyond the role of those related orientations in predicting outcomes. Four outcome variables were chosen because they are theorized (above) as potential long-term effects of EPE. These were information seeking, acceptance of dishonesty, stealth democracy, and openness to reason.
H3: EPE will add a unique positive contribution to predicting (a) information seeking and (b) openness to reason, above and beyond EPE-related orientations and general political orientations. H4: EPE will add a unique negative contribution to predicting (a) acceptance of dishonesty and (b) stealth democracy beliefs, above and beyond EPE-related orientations and general political orientations.

Adjudication, issue interest, and epistemic political efcacy

An interaction between adjudication and issue interest is expected in predicting epistemic political efcacy. To the extent that issue interest serves as an accuracy motivation, it creates a context in which EPE is likely to be accessed and updated based on the success or failure of the attempt to decide which opposing claim is more accurate. Other predispositions such as general political interest, need for cognition (Cacioppo & Petty, 1982; Cacioppo, Petty, & Kao, 1984), or need for closure (Kruglanski, Weber, & Klem, 1993) may in some cases also produce accuracy motivation. However, in the context of a typical news story with a variety of information a reader could focus on (e.g., the personalities, strategies, or conicts of politics) interest in the issues directly under factual dispute seems the best predictor of an effort to mentally resolve those disputes. Other more general predispositions might just as well lead a reader to focus on other aspects of the story. The presence of adjudication should therefore increase EPE for readers who are interested in
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the particular issues under dispute, whereas it may perhaps even decrease EPE for low-interest readers (as found by the pilot study).
H5: Adjudication will interact with prior issue interest in predicting EPE such that the effect of adjudication on EPE will be more positive for readers with high issue interest than for readers with low issue interest.

Recall that the pilot study found a reduction in EPE for low-interest readers in a study using balanced adjudication, meaning a pair of factual disputes in which each side was contradicted about one of the disputes. This may have resulted from the desire among low-interest readers for a cue about which side to trust. If this is the case, balanced (as opposed to imbalanced) adjudication should reduce EPE for low-interest readers, whereas for readers with high interest in the issues under dispute, balanced adjudication should increase EPE because it reassures the reader that the journalist is unbiased.
H6: Balanced adjudication, compared with imbalanced adjudication, will interact with prior issue interest in predicting EPE such that the effect of balance on EPE will be more positive for readers with high issue interest than for readers with low issue interest.

Methods Participants

The data were collected by means of an experiment embedded in a Web-based survey of undergraduate students at a large university in the Midwestern United States (N = 538). Respondents were offered extra credit for participating and were contacted with an e-mail which provided the Web address of the survey. The study took place over a 2-week period in the spring of 2008.
Design and procedure

The experiment dealt with the issue of health care and consisted of both pre- and postmanipulation survey items. Unless otherwise noted, all items used 11-point scales ranging from strongly disagree to strongly agree. After answering pretest questions, respondents were presented with a two-page sequence of experimental stimuli. The rst page contained an expression expectation manipulation, not used in these analyses (but included as a covariate), that led subjects either to expect or not to expect to have to explain the story in their own words. On the following page, respondents encountered one of four versions of a ctional Associated Press news brief about a ctional bill under debate in the house of representatives. Which of the four versions of the story subjects received was also randomly assigned, resulting in an overall eight-cell design. As shown in Appendix A, all four versions of the story were identical in their rst three and their nal two paragraphs, which introduce the bill, provide background on the importance of the issue, and also set up two factual disputes about the bill. In one dispute, opponents
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of the bill claim that its cost will be far higher than the estimated $200 million, and in the other, opponents claim that it is redundant with Medicaid and will create unnecessary additional bureaucracy. Two versions of the news story then adjudicate this factual dispute and two versions do not. The rst nonadjudication story is comparable with the nonadjudication condition from the pilot study because it does not include any additional text in place of the adjudication. It is therefore labeled the shorter nonadjudication story. The second nonadjudication story, the nonadjudicating facts story, contains additional facts so that the story length and amount of information are as close as possible to the two adjudication stories. The rst adjudication story is comparable with the sole adjudication condition used in the pilot study because it resolves the two factual disputes in opposite directions, creating a balanced adjudication story. Which of the two claims by opponents of the bill was supported was randomly determined, and dummies for whether each claim is supported (cost supported and novelty supported) are included in all experimental analyses. The second adjudication story was an imbalanced adjudication story, containing the exact same adjudication text but with both disputes resolved in favor of the same side. Which side they favored was also randomly determined and stored in the same cost supported and novelty supported dummies.
Issue importance

In addition to the news story adjudication and expression expectation manipulations, the analyses examined one additional independent variableinterest in the issue of health care. Prior to reading the news story, respondents were asked to rate, on an 11-point scale, how important a set of political issues were to them. The health care issue interest scale (Cronbachs = .845, M = 7.10, SD = 1.95) was constructed from three items: Health insurance for low-income Americans, The high cost of prescription drugs, and Health care in general.
General political orientations

For control purposes, several general political orientations measured in the pretest were included in some of the analyses. Political interest (M = 5.34, SD = 2.68) was measured using a single item that asked respondents to rate how interested are you in politics, generally speaking on an 11-point scale ranging from not at all interested to very interested. Political knowledge (M = 4.92, SD = 2.32) was measured by a single item that asked respondents to rate how knowledgeable are you about political issues on an 11-point scale ranging from not at all to very. Ideological direction (M = 3.86, SD = 2.15) and its folded version for ideological strength (M = 2.00, SD = 1.38) were based on an item asking where would you place yourself on the political spectrum on an 11-point scale from very liberal to very conservative.
Political efcacy Epistemic political efcacy

Epistemic political efcacy (Cronbachs = .753, M = 5.68, SD = 1.68) was measured using three items: I feel condent that I can nd the truth about political
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issues, if I wanted to, I could gure out the facts behind most political disputes, and there are objective facts behind most political disputes, and if you try hard enough you can nd them.
Internal political efcacy

On face validity, certain traditional measures of internal political efcacy appear to imply an epistemic dimension. Because of this, this study introduces two novel internal political efcacy items intended to tap the efcacy of political action without tapping the epistemic or external dimensions. These are given the opportunity, I feel that I could do a good job inuencing public ofcials and to the extent that citizens can inuence politics, my efforts to do so would be more effective than the average person. In addition to these two items, two traditional internal efcacy items were used to construct the internal political efcacy scale (Cronbachs = .859, M = 4.54, SD = 2.02). These were I consider myself well qualied to participate in politics and I feel that I could do as good a job in public ofce as most other people.
External political efcacy

External political efcacy (Cronbachs = .782, M = 5.45, SD = 1.64) was measured with four items: People like me dont have any say about what the government does (reverse coded), I dont think public ofcials care much what people like me think (reverse coded), Ordinary people can inuence the government, and Public ofcials care what ordinary people think.
EPE-related orientations

This section describes other measures with some conceptual similarity to EPE, included in this study for the purposes of assessing the validity of the EPE scale.
Media trust

Media trust (Cronbachs = .633, M = 4.25, SD = 1.47) was measured using three items: In general, mainstream media can be trusted, Journalists often know too little about the subjects they cover (reverse coded), and Most of the information provided by the mainstream media is incomplete (reverse coded).
Dogmatism

The three dogmatism items had low reliability as a scale (Cronbachs = .333), so each item was used individually. Dogmatism: anticompromise (M = 3.73, SD = 1.88) was To compromise with ones political opponents is dangerous because it usually leads to the betrayal of ones side. Dogmatism: ignore the public (M = 4.30, SD = 2.40) was Our leaders should do what they think is best even if it is not what the public wants. Finally, dogmatism: for or against truth (M = 3.17, SD = 2.42) was There are two kinds of people in this world: those who are for the truth and those who are against the truth.
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Need for closure

Two subscales of the need for closure scale (Kruglanski et al., 1993) were used. Dislike of ambiguity (Cronbachs = .652, M = 5.76, SD = 1.36) was measured using ve items with wordings identical to those used by Kruglanski and colleagues. This general personality scale does not mention politics. A typical item is When I am confused about an important issue, I feel very upset. The other subscale of need for closure is close mindedness (Cronbachs = .626, M = 3.65, SD = 1.32), which was measured using ve items, also identical to those used by Kruglanski and colleagues. As with the dislike of ambiguity scale, this is a general personality measure. A typical item is When thinking about a problem, I consider as many different opinions on the issue as possible. In terms of face validity, close-mindedness seems distinct from openness to reason not only in terms of specicity to politics but also in terms of a focus on reasons or arguments as opposed to opinions or views. The two scales are moderately correlated (r = .297) and their measures separated well into two factors in a factor analysis.
EPE outcomes Information seeking

Information seeking (interitem r = .699, M = 5.47, SD = 2.38) was measured with two items asking how likely on an 11-point scale ranging from not at all likely to very likely they would be to look for more information about issues mentioned in this story or read another news story about related issues, if you encountered one.
Acceptance of dishonesty

Acceptance of dishonesty ( = .747, M = 2.64, SD = 1.82) was I want my political party to tell the truth even when lying would help them win (reverse coded), Theres nothing wrong with bending the truth for a good cause, and Its ok with me if people on my side of a political issue do and say whatever is necessary to win.
Leave it to experts

The four stealth democracy items (Hibbing & Theiss-Morse, 2002) were not used as a scale due to low reliability (Cronbachs = .578). One of the stealth democracy measures was then judged to be relevant on face validity. Leave it to experts (M = 3.93, SD = 2.52) was Our government would run better if decisions were left up to nonelected, independent experts rather than politicians or the people.
Openness to reason

Openness to reason (r = .477, M = 6.58, SD = 1.73) was measured using two items: If I hear a good enough argument against my opinion, I will change my mind and I want the best ideas to win, even if that means my ideas lose sometimes.
Results

Overall, validity of EPE was quite satisfactory, and the basic experimental effect of adjudication by issue interest on EPE, as found by the pilot study, was replicated.
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Within this interaction, the positive effects of adjudication on high-interest readers are signicant but the negative effects on low-interest readers are not.
Validity of epistemic political efcacy

Zero-order correlations between EPE and related orientations are presented in Table 1. Correlations with related orientations generally support its validity. As predicted by H1a through H1c, EPE is positively correlated with internal political efcacy (r = .433, p < .01), positively correlated with external political efcacy (r = .235, p < .01), and positively correlated with media trust (r = .124, p < .05). Hypotheses 2a and 2b were derived from a competing interpretation of EPE measures in which they indicate condence in a close-minded prejudgment of truth instead of condence in the ability to determine it. First, EPE was not positively related to close-mindedness (r = .218), so H2a is not supported. Results for H2b were mixed, with one of the three measures of dogmatism negatively correlated to EPE, one unrelated, and one weakly positively correlated. Overall, there is little support
Table 1 Factor Analysis on Three Forms of Political Efcacy Political Efcacy Epistemic I feel condent that I can nd the truth about political issues If I wanted to, I could gure out the facts behind most political disputes There are objective facts behind most political disputes, and if you try hard enough you can nd them I consider myself well qualied to participate in politics I feel that I could do as good a job in public ofce as most other people Given the right opportunity, I feel that I could do a good job inuencing public ofcials To the extent that citizens can inuence politics, my efforts to do so would be more effective than the average person People like me dont have any say about what the government does I dont think public ofcials care much what people like me think Ordinary people can inuence the government Public ofcials care what ordinary people think Extraction method: principal component analysis Rotation method: Varimax with Kaiser normalization Rotation converged in four iterations .755 .784 .836 .221 .185 .178 .068 Internal .240 .268 .048 .792 .840 .820 .833 External .098 .092 .080 .147 .025 .164 .013

.034 .042 .185 .157

.023 .051 .178 .064

.781 .791 .728 .779

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for the alternative interpretation of EPE as condence in dogmatic or close-minded prejudgment of truth. Of the correlations with EPE in the rst column of Table 2, only internal political efcacy is strongly correlated enough to warrant any concern that EPE items may tap the same underlying construct. A factor analysis containing all items for the three forms of political efcacy is shown in Table 2. Results show a fairly clean separation of the three scales into three corresponding factors. Two EPE items are weakly cross loaded with internal political efcacy at .240 and .268, a major improvement from the pilot study but still not a perfect separation. Also note that the new internal political efcacy items performed well. In fact, the best-performing measure of internal political efcacy was one of the new items: To the extent that citizens can inuence politics, my efforts to do so would be more effective than the average person. Overall, factor analysis suggests that the EPE items are distinct from items measuring its closest conceptual cousins. Turning now to EPEs performance as a scale, perhaps the central validity question is whether EPE adds any utility in predicting outcomes above and beyond internal efcacy and the other EPE-related orientations, as predicted by Hypotheses 3 and 4. To address this question, four ordinary least squares regression models were run, one for each of the four outcome variables. Each model included EPE, all its related orientations, three general political orientations (political knowledge, political interest, and ideological direction), and all experimental factors. Before presenting these results, it is important to note that although similar models could be central results in a representative sample study to assess EPEs unique contribution to predicting these democratically consequential outcomes in the population, given the present sample they are used here only for validation of the EPE construct, with the central result instead being the experimental effects discussed further below on EPE. In the model predicting information seeking, EPE was a signicant and positive predictor ( = .107, one-tailed p = .008), as predicted by H3a. Neither internal political efcacy nor external political efcacy were signicant predictors. In the model predicting openness to reasoning, EPEs coefcient was in the direction predicted by H3b but was not signicant ( = .058, one-tailed p = .108). In the model predicting acceptance of dishonesty, EPE was a signicant and negative predictor ( = .09, one-tailed p = .031), as predicted by H4a. Note also that in this model, in contrast to EPE, internal political efcacy was one of the strongest positive predictors ( = .210, p = .001), whereas external political efcacy was nonsignicant. In the model predicting the leave it to experts stealth democracy belief, EPE was a signicant and negative predictor ( = .178, one-tailed p = .0001), as predicted by H4b. Internal political efcacy was a positive predictor in this same model but was not signicant ( = .104, p = .107). Because these two surprising positive relationships for internal political efcacy are in the opposite direction from the EPE coefcients in the same models, they might perhaps have been artifacts of removing the substantial variance shared by EPE and internal political efcacy. However, when EPE was removed from these models, internal political efcacy remained signicantly and positively related
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Table 2 Zero-Order Correlations Epistemic Efcacy Internal Efcacy External Efcacy Media Trust Dislike Ambiguity CloseFor/Against Minded Anticompromise Truth Ignore Public

1 .433 1 .149 .121 .119 .172 .161 .128 .091 .042 .167 .141 .039 .003 .034 .01 .03 .097 .136 .058 .064 .195 .041 .092 .126 .043 .217 .149 .131 .077 .005 .029 .088 .002 .267 .231 .232 .149 .045 .297 .015 .028 .075 .064 .042 .159 .166 .257 1 .190 .003 .094 .191 .109 .014 .090 .079 .189 .677 .732 .392 .086 .069 .057 .235 .124 .012 .218 .108 .031 .089 .017 .124 .377 .399 .294 .07 .222 .131

Epistemic political efcacy (EPE) related Epistemic efcacy Internal efcacy External efcacy Media trust Dislike of ambiguity Close mindedness Anticompromise For/against truth Ignore public .433 .012 .094 .121 .005 1 .101 .110 .177 .045 .235 .190 .124 .003 .149 1 .005 .094 .001 .072 .133 .218 .191 .119 .094 .101 1 .104 .076 .011 .108 .109 .172 .001 .110 .104 1 .305 .027 .07 .03 .023 .029 .05 .090 .100 .112

.031 .014 .161 .072 .177 .076 .305 1 .115

.089 .090 .128 .133 .045 .011 .027 .115 1 .234 .051 .035 .077 .009 .056 .08 .054

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General orientations Conservative Ideological strength Political interest Political knowledge

Outcomes Info seek likelihood Accept dishonesty Leave it to experts Openness to reason

Epistemic Political Efcacy

Note: Cell entries are Pearson correlation coefcients. Coefcients in bold differ signicantly (p < .05) from the corresponding EPE coefcient in the same row, rst column. p < .05. p < .01.

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to acceptance of dishonesty ( = .181, p = .005) and also remained positively and nonsignicantly related to stealth democracy ( = .055, p = .393). Although these analyses do not warrant any conclusions about the effects of either form of efcacy, their countervailing relationships with such normatively consequential orientations argue for the importance of distinguishing between them. Finally, differences in zero-order correlations are shown in Table 1 to provide a broader overview of EPEs differences in relationships to other variables. Again, Table 1 contains a correlation matrix containing all EPE-related orientations, four general political orientations, and the four outcome variables. Only the left half of the table is shown, containing all rows but only the columns for the EPE-related orientations. R to Z transformations were used to test differences between EPEs correlations with each of the other variables and the other EPE-related orientations correlations with those same variables. Where these tests were signicant at the p < .05 level, the coefcients are presented in bold in Table 1. Note that these tests are not symmetric across the diagonal of the table because each cell is being compared with the corresponding cell in the rst column of the same row (the EPE coefcient for that columns variable). As a result, predictive differences between EPE and its related orientations can be seen by reading down the column for each EPE-related orientation variable. Overall, 80 of 136 possible tests were signicant. Among the outcome variables only, 29 of 40 correlation differences were signicant.
Effects on epistemic political efcacy

Hypothesis 5 was tested using a one-way analysis of variance (ANOVA) model predicting EPE, including issue interest and all experimental manipulations as xed factors, and interactions between adjudication and issue interest as well as adjudication and expected expression. Hypothesis 5, which predicted that the effect of adjudication on EPE would be more positive for high-interest readers than for lowinterest readers, was supported (F (1, 522) = 6.67, one-tailed p = .005). See Figure 1 for a plot of the estimated means of this interaction, which shows the same transverse interaction pattern found by the pilot study. Two planned, one-tailed comparison tests were done on these estimated means. First, among high-interest readers, the estimated mean for the adjudication condition (M = 6.449) was signicantly higher than that for the nonadjudication condition (M = 5.972) at the .05 level. Second, among low-interest readers, the estimated mean for the adjudication condition (M = 5.217) was lower than that for the nonadjudication condition (M = 5.488), but this difference did not reach the .05 signicance level. Two additional one-way analyses of covariance (ANCOVAs) were conducted to test the robustness of these effects. Although random assignment tends to distribute potentially confounding variables equally across experimental groups, it is still advisable to verify that it has done so using all available and appropriate controls (Keppel, 1991). However, ideally such controls would be measured prior to manipulations, and because this study aimed in part to differentiate the dependent variable in this model from existing related orientations, many of these most
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Figure 1 Analysis of variance interaction of story adjudication and prior issue interest on epistemic political efcacy.

obvious controls were measured in the posttest, along with EPE. Because of these considerations, two separate ANCOVAs were used to test robustness, beginning with a model that adds only pretest covariates to the original model. These covariates are ideology, ideological strength, political knowledge, and general political interest. In this model, Hypothesis 5 was still supported (F (1, 521) = 3.600, one-tailed p = .029). Among high-interest readers, the estimated mean within the adjudication condition (M = 6.244) remained signicantly higher than the estimated mean for the nonadjudication condition (M = 5.833), whereas that difference among low-interest readers remained nonsignicant and in the same direction. The nal ANCOVA predicting EPE additionally included controls measured after manipulation. These consist of related concepts that this study aimed to differentiate EPE from: internal political efcacy, external political efcacy, media trust, close mindedness, and the three individual dogmatism items. These variables are included because of theoretical reasons to suspect overlap between them and EPE, such that any effect found on EPE could possibly be driven by effects on these other constructs. Including these variables tests whether the experimental effects are concentrated on the unique part of EPE that does not overlap with these related measures. In the resulting full ANCOVA, Hypothesis 5 is still supported (F (1, 519) = 4.776, one-tailed p = .015). The comparisons between estimated means are also robust
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despite the numerous controls. Among high-interest readers, the estimated mean within the adjudication condition (M = 6.171) remained signicantly higher than the estimated mean for the nonadjudication condition (M = 5.760), whereas that difference among low-interest readers remained nonsignicant in the same direction. Because of the substantial variance shared between EPE and internal political efcacy, the inclusion of internal political efcacy in the above model is particularly important to address any concerns that effects found on EPE are in fact effects on internal political efcacy. To further address this, the original ANOVA model was also conducted with internal political efcacy in place of EPE as the dependent variable. In this model, the interaction between adjudication and issue interest was not signicant (F (1, 522) = 0.02, p = .888). Within the adjudication condition, the nested factor of whether adjudication was balancedwhether the two disputes were resolved in opposite directionswas expected to interact with issue interest. Hypothesis 6 predicted the effect of balanced (vs. imbalanced) adjudication on EPE would be more positive for high-interest readers than for low-interest readers. An ANOVA predicting EPE among respondents in the two adjudication conditions only was used to test this hypothesis. First note that there was no main effect of balance (F (1, 249) = 0.011, p = .918). Although the hypothesized interaction with issue interest was in the predicted direction, it was not signicant (F (1, 249) = 0.925, one-tailed p = .169). The nested factor within the nonadjudication conditionswhether the story contained extra, nonadjudicating facts to make it the same length as the adjudication storiesalso produced no signicant effects on EPE. The main effect of extra facts was not signicant (F (1, 272) = 0.009, p = .924), and the interaction of extra facts with issue interest was not signicant (F (1, 272) = 0.829, p = .363).
Discussion

In summary, this study offers a reliable and valid measure of EPE, offers evidence that it is distinct from its closest conceptual cousins at the level of individual items and predictive differences, and demonstrates that exposure even to a single news story that contains adjudication (compared with one that does not) has at least a short-term effect on EPE. The direction of this effect may depend on prior interest in the issues under dispute in the news story. In particular, we can conclude with some condence that for high-interest readers, adjudication increases EPE. However, effects on low-interest readers are less clear.
The low-interest reader problem

Although the surprising nding of the pilot study in which adjudication decreased EPE among low-interest readers was not statistically signicant in this study, it was in the same direction and close enough to signicance to warrant concern that adjudication may reduce EPE for some. If real, this negative effect would make it less clear what to recommend for journalists to do on the basis of this research.
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However, it is important to put it in context. Specically, we should consider its meaning beyond an experimental context in which people are randomly assigned to read a news story. Of course, in the real world, people self-select news stories to attend to, making effects on high-interest readers arguably more externally valid than those on low-interest readers. This is particularly applicable to textual news or more generally for any news in which readers select stories. Even with other media, people may stop paying attention during stories they are not interested in. Students asked to read a news story in the context of receiving extra credit for a class are of course not forced to pay attention or read the story at all, but there is certainly more articial pressure to do so than in any natural news use context. Future experiments should test whether these effects disappear when subjects are allowed to choose from a set of story topics. In summary, we can be fairly condent of the positive effects of adjudication on EPE for higher interest readers. Their external validity is not as questionable as the effects on low-interest readers, and the effects were consistent across the two studies despite their different topics and somewhat different measurement of EPE. Furthermore, these effects did not appear to be due to the mere presence of additional facts that adjudication requires. Negative effects on low-interest readers were not as consistent across studies, and even if they prove real in the laboratory, may be less relevant in the real world due to selective exposure and attention. If one had to recommend anything on the basis of this nascent research program, it would be to do more adjudication, except perhaps of disputes about which audiences are uninterested. The best explanation for any negative effects on low-interest readers in the pilot study was that they were seeking a cue about which side to trust, so the balanced adjudication reduced their EPE by making both sides seem untrustworthy. Unfortunately, the lack of difference in effects of imbalanced versus balanced adjudication in this study cannot be taken as evidence against this explanation because the two sides in this study were given no concrete identities. Both sides were labeled bipartisan groups of lawmakers. Future research should compare balanced and imbalanced adjudication in a context of identied groups. It is also possible that for low-interest readers who are seeking cues about who to trust, any adjudication that appears to indicate that any political actors statements were intentionally deceptive may reduce EPE via a general reduction in trust in political actors. Future experiments should measure relevant trust constructs after exposure to the news story. Furthermore, it is possible to design forms of adjudication that imply an honest mistake instead of a lie on the part of the contradicted source. This aspect of adjudication could be manipulated in future experiments. Note that this mechanism of EPE reduction via a reduction in generalized trust may be particularly strong when the groups are not identied, as in this study. If the low-interest reader problem does in fact prove to be robust and generalizes to natural settings involving news story choice, it would be important to then examine the effects of hyperlinked adjudications in which readers have to click on a fact check link within an online news story to get the adjudication. Because low-interest readers would be less likely to click on such links, such an approach could constitute
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an important renement in the recommendations this line of research can make for journalistic practice, at least in the increasingly relevant context of online journalism.
The EPE construct

Although the construct validation work here should be replicated in the future using a nationally representative sample, this study did greatly improve the measurement and validation of EPE. In particular, the factor analysis in Table 2 clearly distinguishes EPEs items from those of other political efcacy constructs. Concerns that EPE taps dogmatic prejudgment of truth, as opposed to condence in an ability to open-mindedly ascertain it, were laid to rest by EPEs moderate negative correlation with close-mindedness and the general lack of relationships to dogmatism items. The replication of the core experimental nding of the pilot study is consistent with expectations derived from self-efcacy theory that EPE may be built up over time by instances of journalistic adjudication or suppressed over time by overly passive, neutral journalism.
EPE outcomes

A third crucial step in establishing this constructs importance and motivating future research on it is to test its theorized consequences. The primary empirical focus thus far has been on the rst two steps of measuring EPE and assessing the effects of adjudication on it. The present data are not ideal for addressing questions about outcomes of EPE. Overall, it is impressive enough that reading a single news story about a single topic has signicant effects on generalized EPE. It would be surprising indeed if the relatively small effects that a single news story can produce on EPE were enough to carry over into signicant mediated effects on any theorized outcomes. Furthermore, although analyses predicting outcomes using EPE and controlling experimental effects are of course possible with this data set, it lacks any detailed media use measures that could act as indicators of past exposure to adjudication. Future research should test the theorized mediating role of EPE between journalistic adjudication and theorized outcomes such as information seeking, acceptance of dishonesty, stealth democracy, and openness to reason. With the above qualications aside, certain results of the regression analyses presented here should motivate a careful second look at the normative status of internal political efcacy, as it relates to forms of engagement with politics. Both political engagement and internal political efcacy are often thought of as unambiguously positive. However, in this studys (tentative) regression analyses, internal political efcacy had a positive relationship with acceptance of dishonesty, a strongly negative citizen quality. It may well be that a focus on the problem of how to encourage citizen engagement has led to a blind spot for forms of engagement that are bad for democracy. Future research should attempt to make ner distinctions in forms of political engagement, with particular attention to those with some negative consequences, such as the Machiavellian ones that might be expected from those who accept dishonesty as a means to achieving political goals, or more generally, truth-disregarding forms of engagement that might be expected from those with very low levels of EPE.
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Conclusion

Just as traditional measures of political efcacy have been useful with regard to citizen behaviors oriented toward affecting politics, epistemic political efcacy promises to shed light on citizen behaviors oriented toward understanding it. The measure of epistemic political efcacy developed here appears to be reliable and valid, although conrmation using a representative sample is an important next step. Furthermore, the two experiments conducted thus far are consistent in nding that at least for readers who are high in prior interest in an issue, encountering even a single news story about that issue that contains adjudication signicantly increases their epistemic political efcacy. This suggests that journalistic adjudication may be a point of leverage for increasing the quantity and quality of citizen engagement: goals that may seem unattainable when one assumes that their only important antecedents are motivational constructs such as political interest. However, these short-term experimental effects of adjudication may or may not accumulate over time and may or may not be countered by opposite effects on less interested audience members. Future research should attempt to address the external validity and stability of these effects, while also extending them to examine effects that EPE may have in turn on democratically consequential outcomes. It is hoped that this study will also be useful for researchers interested in other effects of journalistic adjudication. As noted above, whether journalists adjudicate factual disputes has long been a focus of theories of the ideal role of journalism, but past research had not tested for the effects of adjudication on audiences. This study demonstrates the empirical tractability of adjudication manipulations by isolating them from story length, the number of facts presented, and balance. This study can serve as a model for testing other outcomes of adjudication. One such outcome particularly consequential for democracy would be increased factual polarization across partisan lines. In recent decades, factual polarization has increased, possibly signaling a fundamental shift in the nature of political polarization with important consequences for democracy (Shapiro & Bloch-Elkon, 2008). Less than ideal levels of journalistic adjudication of factual disputes may play a role, connecting this critique of factual polarization to critiques of passive journalism while also suggesting that certain media reforms (e.g., Nichols & McChesney, 2009) may be a point of leverage for bringing together our increasingly contradictory partisan factual universes, as long as those reforms allow more reporter-hours devoted to adjudication, and ultimately more adjudication content in news stories.
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Sweetser, K. D., & Kaid, L. L. (2008). Stealth soapboxes: Political information efcacy, cynicism and uses of celebrity weblogs among readers. New Media & Society, 10, 6791. Tuchman, G. (1972). Objectivity as strategic ritual: An examination of newsmens notions of objectivity. American Journal of Sociology, 77, 660679. Wells, S., & Dudash, E. (2007). Whadya know? Examining young voters political information and efcacy in the 2004 election. American Behavioral Scientist, 50, 12801289.

Appendix A News story News briefHouse to vote on prescription drug bill

WASHINGTON (Associated Press)The House of Representatives will vote next week on controversial legislation that would subsidize prescription drug costs for uninsured, low-income Americans with certain life-threatening conditions. This legislation, sponsored by a bipartisan coalition, is facing opposition from members of both parties. Opponents have made two arguments against the bill. One is that it is redundant with Medicaid and would create unnecessary and costly additional bureaucracy. The other is that the plans costs may grow far beyond the $200 million estimated by its proponents. Supporters dispute both arguments, claiming that the proposed legislation covers medications that Medicaid does not and that their $200 million estimate is its maximum possible cost.
Non-adjudicating facts condition

Two independent reports on the legislation have added fuel to the debate in the past week, one by the Duke University Center for Health Policy and one by the Washington-based nonpartisan Economic Policy Institute. Both reports include detailed analyses of the bills annual cost. Medicaid is administered separately by each state. The program differs greatly from state to state, although its focus is always on lower-income people.
Balanced adjudication condition

Two independent reports on the legislation have been released in the past week, one by the Duke University Center for Health Policy and one by the Washington-based nonpartisan Economic Policy Institute. Both concluded that $200 million greatly underestimates the bills annual cost. Medicaid does include provisions for certain prescription drug costs, but does not cover any of the medications in this legislation.
Imbalanced adjudication condition

Two independent reports on the legislation have been released in the past week, one by the Duke University Center for Health Policy and one by the Washington-based
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nonpartisan Economic Policy Institute. Both concluded that $200 million greatly underestimates the bills annual cost. Medicaid does include provisions for certain prescription drug costs, and includes all of the medications in this legislation. Forty million Americans lack health insurance at any given time. Other than unemployment, common reasons for a lack of coverage include job transitions, waiting periods for new employees, employers who do not provide coverage, and denial of individual coverage due to preexisting conditions. A lack of health insurance leads to an estimated 18,314 deaths per year in the United States, according to a study by the Institute of Medicine.

Journal of Communication 61 (2011) 2247 2011 International Communication Association

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