Myths can be hard to debunk—particularly when centered on contentious issues like access to and affordability of health care.

Marketing and public policy professor Peter Ubel, along with colleagues Brendan Nyhan of Dartmouth College and Jason Reifler of Georgia State University, researched how Americans continue to think about the “death panel” myth. The term was coined by Sarah Palin in 2009 to characterize a part of the Affordable Care Act that would create a group of government officials to decide who receives health care. The researchers found that some Palin supporters, when presented with corrections to the myth, were actually more likely to strengthen their belief in death panels rather than accept contradictory evidence. The findings, entitled “The Hazards of Correcting Myths about Health Care Reform” will be published in the journal Medical Care in February.

“The death panel myth—people have been debunking it forever,” Ubel said. “We can’t expect fact checking alone to work. We need to be very strategic in how we go after the truth.”

The researchers’ experiment centered around giving groups of people a news article on health care reform. The article one group received included a correction by nonpartisan health care experts explaining that there is no evidence to support the existence of a death panel provision in the Affordable Care Act. Palin’s more politically savvy supporters were found to be more likely to actually strengthen their beliefs in death panels after viewing corrections, whereas less knowledgeable individuals were more likely to change their opinions.

Palin introduced the myth in a debate on federal health care legislation when she claimed that the bill proposed by the Obama administration would initiate panels of bureaucrats who would decide whether subsets of the American population, such as seniors or patients with Down syndrome, were “worthy” of health care.

The results of the study could indicate problems the Obama administration may face in implementing the Affordable Care Act, Ubel said. Although passed in 2010, much of the law’s provisions have yet to take effect, and public opinion could change how those provisions are enacted.

Ubel believes the persistence of the death panel myth could be particularly irksome when it comes to implementing the Independent Payment Advisory Board, which is charged with achieving savings in Medicare while maintaining coverage and quality. The group was the target of Palin’s 2009 accusations, though her claims were unfounded.

Despite these inaccuracies, recent polls have indicated that almost half of Americans believe that the Affordable Care Act creates death panels, Ubel noted.

“If Republicans are saying cost control means death panels, that will have a large bearing on how we control costs of health care in the future,” said David Ridley, associate director of Fuqua School of Business’s program in health sector management. “If there’s not someone saying ‘no’ to high costs, then costs will continue to grow rapidly.”

Due to the “backlash effect”—some individuals were more likely to believe in death panels after being confronted with corrections—it is difficult to make headway in correcting the myth, Ubel noted.

“It may only go away once Obamacare has been here long enough,” he said. “You almost have to find someone credible to the believers. Maybe you need a Republican to come out and say there are no death panels.”

He added that though his findings were “disturbing and bothersome,” he was not surprised that some people were more likely to believe in the myth after being presented with corrections—previous research has indicated similar backlash effects in other fields.

But the backlash effect may have deeper political implications, Don Taylor, associate professor of public policy, suggested, adding that it may have more to do with individuals disliking the president than with concerns over the Affordable Care Act.

“The bottom line is that a lot of people are predisposed to be opposed to Obama generally, and health care is his signature law,” Taylor said.

For Ridley, the subject matter of the study could also relate to a change in political climate. Although it is unsurprising that politicians would use fear of death panels as a tactic to build opposition to the Affordable Care Act, he noted, disapproval comes from those who usually support cutting costs.

“I’m surprised that Republicans are especially guilty of propagating this belief because historically many Republicans have favored forms of cost control,” he said.