Daily Beast: Former Confederate States Hurting Blacks by Not Expanding Medicaid

October 3rd, 2013 3:48 PM

When you have to toss out in the midst of your race-baiting article that you are in no way insisting that conservatives are racists, well, that's pretty good evidence that you're doing just that.

"No, this is not a convoluted way of calling Republicans racists,"Jamelle Bouie insisted -- and which editors placed into a pull quote -- in his October 3 story "How the South Blocked Health Care for Those Who Need It Most."   "Thanks to Republican legislators in old Confederate states, universal health-care won’t be so universal" laments a front-page caption accompanying a stock image of a black girl being attended to by two black medical personnel in surgical scrubs. [see image below the page break] Here's how Bouie opened his story on the lack of Southern states participating in a Medicaid expansion available to them under ObamaCare:

By the time it was fully formed, the Confederacy had eleven member states: Virginia, North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Mississippi, Arkansas, Louisiana, Texas, and the territory that is now Oklahoma.

This, with the exception of Arkansas, is also a partial list of those states that have rejected the Medicaid expansion under the Affordable Care Act. As the New York Times points out in today’s must-read story, the direct result of this is to block millions of Americans from access to health insurance. And while Southern states don’t comprise the majority of those that aren’t expanding Medicaid, the majority of people who will suffer are poor, black, and in their borders. These are some of the most vulnerable people in the country—with terrible outcomes on most measures of well-being—and Obamacare won’t help them.

Now, you could call this a coincidence, but then you’d have to grapple with a few things. First, that these are states which—in the aftermath of the Supreme Court’s ruling on the Voting Rights Act—passed draconian voter identification laws that limit access and burden low-income blacks with onerous requirements. In North Carolina, for instance, Republicans banned paid voter registration drives, removed a week from the early voting period, eliminated flexibility in voting hours, and made it difficult for precincts to designate additional voting sites for the elderly or those with disabilities. The effects of this are so disparate as to compel action from the Justice Department, which is suing North Carolina–and Texas—for alleged racial discrimination in voting rights.

These are also states characterized by the most racially polarized voting in the country. The overwhelming majority of Republican voters in states like Mississippi and Alabama are white, and the overwhelming majority of Democratic voters in those states are black. As a recent paper found, “General Social Survey and National Election Studies data from the 1970s to the present indicate that whites residing in the old Confederacy continue to display more racial antagonism and ideological conservatism than non-Southern whites.”

Having all but slammed Republicans as racists, Bouie decided to close his article a few paragraphs later by essentially arguing that Republican policymakers in the South may not be setting out to create racist public policy, it's just that they can't help but doing so when they pursue policies that do not expand the welfare state as liberals would prefer (emphasis mine):

No, this is not a convoluted way of calling Republicans racists. It is, however, a reminder that the political culture of the South is profoundly shaped by race. “Contemporary differences in political attitudes across counties in the American South trace their origins back to the influence of slavery’s prevalence more than 150 years ago,” note political scientists at the University of Rochester in a paper exploring the legacy of slavery. Race, simply put, is encoded in the politics of the South. Lawmakers can have “colorblind” motives, but there is no colorblind policy: To reject the Medicaid expansion is to disadvantage African Americans. There’s no other way around it.

This raises a disturbing question. If Medicaid is an anti-poverty measure, and if it the expansion is meant to provide an additional floor of support for low-income Americans, what happens when there’s a large racial divide in who benefits, itself a product of past racism? At The Atlantic, Ta-Nehisi Coates ++looks++ at this racial disparity and connects it to past expansions of the social safety net, which—for similar reasons—either excluded blacks or left them with fewer benefits. He writes that with Obamacare, “one can see how an ostensibly, and well intentioned, progressive and color-blind policy proposal can actually expand a wealth gap.”