According to Politico, South Dakota's upcoming approval of Medicaid expansion is likely to be the last one for quite a while. So this is the Medicaid map we're going to have for at least the next few years:
The Black population makes up 14.2% of the entire United States. You will be unsurprised to learn that the average Black population of the Southern holdouts is 24.3%. Only the three Midwestern states have lower than average Black populations.
The Southern holdouts all have stories to tell about why they refuse to accept Medicaid expansion. It's not part of their culture. They're afraid it might cost too money down the road. They already have plenty of programs for their poor people. Etc. etc.
But what they really mean is that federal money is fine unless it's mostly going to go to low-income Black people. That's been the problem with the American safety net for decades, and it still is today.
"Only the three Midwestern states have lower than average Black populations."
I see only two Midwestern states on your map: WI and KS.
WY is a Rocky Mountain state.
If you are black, there are no really good places to live in America, but I’ll never understand why they live in Mississippi.
Its not for nothing that Nina Simone wrote the song Mississippi Goddam.
FDR only got southern Democrats on board with the Social Security Act by making sure it excluded agricultural and domestic workers (i.e. most Southern Black labor). Same as it ever was.
Don't you go talking that CRT stuff!
""Our staff is like family." Strom Thurmond
(Or so people have said he said.)
I suspect Strom's illegitimate bi-racial (aka "black") daughter didn't feel much "like family."
Just goes to show how much the rest of Wisonsin hates the people of Milwaukee proper.
Wisconsin has BadgerCare. It predated ACA and was a model for ACA. Though Medicare expansion would have patched some holes in BadgerCare, it was not fixing a massive problem. Of course, this doesn't mean racism is not some part of the equation but it is not the whole story.
I thought Kansas had passed it am I thinking of something else ACA related?
Wow. States are willing to hurt their poor white populations because poor black people will be damaged more. Gotta keep them down. I was glad that Texas did not take the Medicaid expansion money. Maybe it was the wrong decision (I am a budget hawk and feared the federal aid would be pulled at some point), but it was not racist on a personal or state level.
States are willing to hurt their poor white populations because poor black people will be damaged more.
I sense an attempt at irony on your part, but this sentence of yours describes the situation perfectly. And it's always been this way in vast swaths of the old Confederacy.
Summarized in Davis X. Machina's legendary axiom over at Balloon Juice some years ago:
"The salient fact of American politics is that there are fifty to seventy million voters each of whom will volunteer to live, with his family, in a cardboard box under an overpass, and cook sparrows on an old curtain rod, if someone would only guarantee that the black, gay, Hispanic, liberal, whatever, in the next box over doesn’t even have a curtain rod, or a sparrow to put on it.”
I don't know that you are wrong to point to racialized institutional thinking, but it is important that the Medicaid expansion is not free. It's a really good deal, but does require states to chip in a bit more dough, and some of them didn't like that.
And yeah, I think many of them were worrying, or perhaps hoping, that the spigot might get turned off at some point in the future, and it's much worse to take something away from people than it is to never give it to them.
This is one of the places where I feel my own bubble, because I didn't understand this about the whole Obamacare legislation until several years into it. My liberal bubble never represented the arguments, just framed the refusal as petulance.
I mean, there was some political performance of petulance, for sure. I'd like to understand the actual motivations of the other side, though. It's valuable to me, much more valuable than the usual pejorative mind-reading you might get.
<i<It's a really good deal, but does require states to chip in a bit more dough, and some of them didn't like that.
Yes. This was a flaw in the original legislation AKA an example of Democrats being stupid. Not only has it provided fiscally conservative (read: regressive) states with an excuse not to improve the health of the Americans who live within their borders, the issue also gave the Supreme Court a rationale for ordering the Medicaid expansion component to be voluntarily.
The Obama era saw some truly epic own goals by Democrats.
I should add, though, that the costs to the states of expanding Medicaid are pretty trivial, I'm pretty sure. The ten percent they're required to kick in is only for the additional Medicaid spending called for by the ACA, which itself is only about 15% of the total. in other words, states are being asked to kick an additional amount equal to about 2% of the program's cost in their state, on average (back of envelope calculations). And the the cost on net is lower, because that two percent brings with it an amount nine times greater courtesy of the Federal Government, which increases incomes in the state, and thus juices tax collections based on incomes, sales taxes, corporate profits, etc.
There's a reason these states congregate toward the bottom of the heap in terms of incomes and economic well-being: policy.
And that's ignoring that a healthy population is better for the economy.
Yep.
This article frames this as a racial bias, yet I wonder if the issue might be more complex.
1) Wyoming is 1% black and blacks are 5% of Kansas. The discrimination argument for those two states is unclear or weak.
2) I know that Texas has an analysis that shows they would have to implement an income tax (Texas currently has not income tax) if they expanded Medicaid. Perhaps you believe that is a wise tradeoff: however, don't discount how big of a political obstacle it would be for Texas to change its tax status.
3) Florida , similar to Texas, has not state income tax. I am not aware if an income tax would be required for expansion (have not seen data) but certainty the GOP would contend that a tax change would be required.
Overall, I don't discount that bias plays a role in non expansion: rather, I think the opposition is more complex than just an anti black sentiment.
"Overall, I don't discount that bias plays a role in non expansion: rather, I think the opposition is more complex than just an anti black sentiment."
If you are arguing that it's classism rather than racism I will grant that point - but in America, there isn't much difference between the two.
Also, the "Obama" in Obamacare is a black man. And everyone in WY knows it.
I seriously doubt whether the residents of WY are any more racist than the residents of all the other nearby mountain states. More racist than Idaho? I really doubt it.
WY is, however, the smallest population state, and it has a very small state budget, which is probably pretty fragile. I'm sure they are worried by the impact of becoming a "magnet" for less well-to-do people. Yeah, there's always a racial component to that, but see my first sentence.
What another state might consider a flea bite in terms of budget could well be a knockout blow to WY's budget. I expect they are cautious on this score. Life on the range is hard, and that breeds a cautious temperament.
Wyoming relies heavily on resource extraction for its revenues. And it tends to be boom/bust. So I could easily see them being nervous of such things.
Obviously, if you're poor you don't deserve medical care. /s
Back in the 2010 (I think; it might have been 2008) election, Grayson correctly described the Republican two part health care plan for poor people:
1. Don't get sick
2. If you get sick, die quickly.
Republicans do a lot of bad things - and refuse to do a lot of good things - but for my money refusing to expand Medicaid is the most cruel, most illogical and most un-Christian of all. Thousands of Americans die every year - and many more suffer needlessly - because the GOP is still butt hurt about Obama.
And I hate them for it.
Another map in the Find the Confederacy collection
Maybe a rational for forgoing Medicare expansion was the hope that their local "POC" would move to a state that expanded?
I remember there used to be a program to bus their indigent folks to California. That must be where DeSatanis got the idea.
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Ya know? The "Southern States" could solve this problem of being Tail-End Charlies all the time if they'd just let African Americans meet their full potential. But that would mean that the poorest, least-skilled What Foulks wouldn't have anyone to look down on.
Priorities.