She discovered documents supporting the Kochs' investment in Buchanan's Center for Study of Public Choice, and this led her to develop her hypothesis about right-wing politics in the U.S. for the book.

[6][3][4] This book focuses on the Nobel Memorial Prize in Economic Sciences-winning political economist James M. Buchanan and his work developing public choice theory, as well as the roles of Charles Koch and others, in nurturing the libertarian movement in the United States.

MacLean argues that these figures undertook "a stealth bid to reverse-engineer all of America, at both the state and national levels back to the political economy and oligarchic governance of midcentury Virginia, minus the segregation.

"[9] George Monbiot, climate science author and columnist for The Guardian, wrote that the book was "the missing chapter: a key to understanding the politics of the past half century.

[15] For NPR, Genevieve Valentie wrote the book "feels like it was written with a clock ticking down" after a "sixty-year campaign to make libertarianism mainstream and eventually take the government itself.

"[16] Marshall Steinbaum of the Roosevelt Institute described himself as "in sympathy with MacLean’s characterization of the Virginia School as profoundly antidemocratic and anti-academic" and called the book "an important warning, and it should be read by all despite its rhetorical shortcomings.

"[18] MacLean was an invited guest on several popular television and radio outlets, most notably Real Time with Bill Maher, where she appeared twice (in August and November 2018) to discuss contemporary politics and the history of the far right.

[23] Jonathan H. Adler noted allegations of serious errors and misleading quotations in Democracy in Chains raised by Russ Roberts, David R. Henderson, Don Boudreaux and others.

[33][34][35] In response, MacLean said she was the target of a "coordinated and interlinked set of calculated hit jobs" by "the Koch team of professors who don't disclose their conflicts of interest and the operatives who work full time for their project to shackle our democracy".

Henry Farrell and Steven Teles called the book a "conspiracy theory in the guise of intellectual history"[42][2] and wrote, "while we do not share Buchanan's ideology ... we think the broad thrust of the criticism is right.

[44] Jack Rakove wrote that there "should be a thorough scholarly review of these points [raised by critics], and one suspects that MacLean will have to make a more concerted effort to justify her argument than she has yet provided".