Expansion of Medicaid Under Affordable Care Act: The Elephant in the Living Room (Hint: Fergit, Hell!)

Yesterday, I linked to an article by Stephen Mihm in the Boston Globe in which Mihm notes that socioeconomic inequality thrives in the states of the old Confederacy — the slaveholding states of the American Union — as a direct and intended result of the slave system. As Mihm points out, from Emancipation forward, the powers that be in the South have been conspicuously resistant to "public goods" — to schools, libraries, and other institutions that serve the public good by serving everyone. White Southerners have been ambivalent about such institutions quite specifically because they serve white and black citizens, the descendants of slaveholders along with the descendants of slaves.

As I cited Mihm, I juxtaposed his argument about the resistance of the states of the former Confederacy to institutions serving the public good with a recent essay by Edward McClelland about why white Southern men dislike labor unions and regard them as a threat to the Southern "way of life." The dislike of white Southern working-class males for unions is part and parcel of a wider cultural penchant for resisting any and all institutions that serve the public good — and, therefore, the good of black Southerners mired in generational poverty after the Civil War. To an extent unimaginable to people raised outside the cultural context of the American South, the ethos of the common good is astonishingly weak among white Southerners, and that weakness is reinforced by the individualistic notions of salvation that dominate evangelical religion in the South.

And now today I see David Kurtz's quip at Talking Points Memo that the elephant in the room as we discuss resistance to the Affordable Care Act is the following:

[T]he holdout states are clustered in the South, where African Americans are most affected by the lack of Medicaid coverage.

The link points to another TPM article by Dylan Scott that reports,

Medicaid expansion is making progress. As TPM reported yesterday, even states as conservative as Wyoming are coming around. Others like Indiana and Pennsylvania are making progress as well. But a handful remain hardened in their opposition. They are largely contained to the South, and that means that the people being left out of Obamacare's safety-net expansion are disproportionately poor blacks. 

Scott cites Nelson Lichtnestein, director of the University of California-Santa-Barbara's Center for the Study of Work, Labor, and Democracy, who noted in June,

A ruling white caste (is) now putting in place policies likely to create a vast economic and social gap between most Southern states and those in the North, upper Midwest and Pacific region. Of course, such regressive social policies... are supported by a fierce white partisanship.

There's a reason why the states of the old Confederacy went solidly Republican (among white citizens, that is) following the enactment of the Civil Rights Act under a Democratic administration in 1964. There's a reason that the Republican party pandered to white Southerners outraged at the passage of civil rights legislation ending legal segregation. There's a reason that Republican-controlled legislatures in these same states are now trying to curb voting rights of racial minorities and have gerrymandered districts to assure that white Republican votes count more than any other votes at election time.

And there's a reason that the states of the old Confederacy are now the holdout states when it comes to expansion of Medicaid under the Affordable Care Act. All of these reasons are one single reason, in fact.