Sunday, October 13, 2013

Color of Affordable Care


Nancy Folbre is professor emerita of economics at the University of Massachusetts, Amherst.

Shortly after House Republicans shut down the federal government in an effort to halt implementation of the Affordable Care Act, Sabrina Tavernise and Robert Gebeloff of The New York Times reported that many Republican-controlled states have already strangled an important feature of the legislation by denying extension of Medicaid eligibility to the working poor.
Since the federal government committed to shouldering most of the cost of such extensions, the officials running these states seem to be cutting off their own noses to spite their faces. Then again, perhaps the noses they are cutting off are not their own.
Neither Republican officials nor their most valuable constituencies need help paying for health insurance. When they say they oppose government spending what they really mean is that they oppose spending on programs like Medicaid that – unlike universal programs such as Social Security – target low-income families.
The disparate racial impact is striking: 68 percent of poor and uninsured blacks live in states that are not extending eligibility, compared with 58 percent of poor and uninsured persons in other racial categories.

The concentration of negative effects in Southern states that also represent the stronghold of Congressional opposition to the law itself is not surprising. This episode of political history fits neatly into an established line of research that shows how federal efforts to extend protections to the disadvantaged have repeatedly fallen prey to a toxic blend of racial and regional politics. From civil rights to health insurance, white political leaders from states with large numbers of African-Americans — especially but not exclusively in the South — have cast new federal protections in apocalyptic terms and mounted a powerful opposition.
In her pioneering book “The Color of Welfare,” published in 1994, the sociologist Jill Quadagno persuasively documented the race-based politics that sent the United States down a policy path very different from that of other affluent countries, blocking the federal extension of most universal social programs other than Social Security and Medicare and giving states significant control over means-tested programs targeted at the poor. This control allowed politicians in Southern states to restrict benefits for low-income families, whatever their color.
A host of academic studies have explored the impact of intersections between race and class, noting, for instance, that in states with larger black populations race becomes more salient to the politics of social provision, altering the dynamics of social and political trust. Poor whites are promised protection against labor market competition or higher taxes in return for acquiescence with policies that restrict the social safety net.
As the Stanford economist Gavin Wright shows in his new history of the Civil Rights Movement, “Sharing the Prize,” Southern whites often overestimated the costs – and underestimated the benefits – that integration would bring them.
In “Disciplining the Poor,” an analysis of welfare reforms introduced in the mid-1990s, Joe Soss, Richard C. Fording and Sanford F. Schram demonstrate that states with a large number of African-Americans (especially but not exclusively in the South) imposed particularly stringent rules on access to public cash assistance, as well as keeping benefit levels extremely low.
In “Taxing the Poor,” Katherine Newman and Rourke O’Brien show that state income and sales taxes in the South are far more regressive than those in other regions of the country, penalizing all low-income families.
Overt racism and outright discrimination now elicit strong social disapproval, but racial bias takes a more subtle, coded form. In “Why Americans Hate Welfare,” Martin Gilens documents a tendency for Americans to systematically overestimate the percentage of public welfare spending going to blacks. His content analysis of pictures accompanying stories about poverty in three major newsmagazines between 1967 and 1992 showed that the frequency with which African-Americans were depicted far exceeded their actual representation in the population.
An Associated Press survey of racial attitudes conducted immediately before the presidential election last year clearly suggests that most Americans try not to discriminate, but that racial loyalties shape their perceptions of economic benefits.
When asked if President Obama’s race affected the likelihood they would vote for him, 80 percent of respondents said no. Yet 28 percent of respondents believed that his policies had made black Americans better off, compared with only 15 percent who believed they had made white Americans better off.
I don’t know of any analysis of the president’s economic stimulus program – or any other policy – purporting to show that blacks benefited more than whites. Indeed, the comparison itself is oddly optimistic, because neither black nor white Americans outside the top 1 percent of the population have enjoyed significant increases in family income since 2009.
Respondents predisposed to believe that a black president will try to benefit blacks more than whites are likely to view the Affordable Care Act through a racial lens, which helps explain the results of a recent Pew survey showing that almost 91 percent of blacks currently approve of the law, compared with 29 percent of whites.
This approval gap overshadows the effect of factors directly relevant to eligibility for assistance. Among those with annual family incomes of less than $50,000, 50 percent currently approve of the law, compared with 38 percent of those with higher incomes (who are less likely to benefit from it).
It’s important to note that many people who don’t approve (about 17 percent, according to a recent Kaiser Foundation poll) feel the Affordable Care Act doesn’t go far enough in reforming the way we pay for health care. Further, the complexity of the legislation makes it difficult for individuals to predict its economic consequences (the Pew survey reported that only 25 percent of poll respondents said they had a very good understanding of how the law would affect them).
Controversy and confusion make it easier for politicians to prey on pre-existing prejudices that serve their own interests better than those of their least influential constituents, as became apparent in the first stage of the civil rights movement.
This movement has yet to reach its final stage. Access to affordable health insurance should be considered a civil right for everyone.

10 comments:

Anonymous said...

This article is about the way people let race determine what or who they vote for and if and how they are discriminated against. One of the first issues talked about in the article is where poor blacks and whites live and whether or not the states they live in are extending eligibility for programs like Medicaid or welfare. To be blunt, races should not matter and it is 100% stupid that they do. Why there has to be two different statistics for the color of people's skin is something I will never understand or accept. However, more black people are living in places where eligibility is not extended by 10%. This poses an issue because if our citizens who need help aren't getting it, the problem will only worsen and the gap between rich and poor will increase. Politics in general are another category where racial profiling is inevitable. States having significant control over means-tested programs allowed many Southern states to restrict benefits for low-income families, regardless of their color. Even though it was regardless the color of it's citizens, more low-income citizens there are black so it's instantly viewed as a racial thing. States with a larger amount of black people become more salient to the politics of social provision which alters the dynamics of social and political trust. But, poor whites are promised protection against the labor market competition or higher taxes. People's estimations of taxes and benefits and other things they can't control are typically far from what they truly are. Costs are overestimated and benefits are underestimated causing wrongful emotions towards politicians and the government. While Obama was running for president, it was stated that he would do things to benefit the blacks more than the whites. As wrong as it is, some people based their vote on that alone. Racial loyalty is something that should have been forgotten a long time ago, at least enough to not alter who you'd vote for as our president. Even thought the racial issue hurts us as citizens politicians take advantage of the confusion and controversy. They prey on pre-existing prejudices that serve their own interests. While this is good for them, it will not help the issue of how much or how little the rest of the nation trusts them. If our country could put the whole race thing behind us as it should have been done a long time ago, a large amount of our problems would vanish.

-Brittani Muller

Anonymous said...

Its basically a battle between race and standard of living. It should not always be about these two categories. The government should be working together to satisfy all parties in some way or another. I know it is hard to please everyone but there is no need to get your point across by shutting down the government. Many times throughout this article race and lower class is being described. I think the main reason why the shutdown came about is because the republicans do not want to pay the extra taxes in order to keep the lower class up to standards. Having the same tax would not be fair because some people cannot afford the same amount of tax as another person from a different class. It is unfortunate that this had to happen but if it did not, I'm not sure the lower class and even some middle class people would last. Obama did say he would do things for the lower class in order for them to stay on track if he did become president and that is exactly what he is trying to do. This has led to a stalemate in government.

-Vincent Barbetto

Anonymous said...

It is nothing new it is typical politics. Race always is a huge factor. Unfortunately the same group always gets the short end of the stick.Whenever different racial groups are in jeopardy it depends on what race they are in which who will get let off easy. Poor whites are sometimes guaranteed protection from certain situations unlike the other racial groups. Decisions such as healthcare should not have to concern it self with race. People are still human beings and even though they might be poor what ever little money they do spend does get circulated back into the economy. If the government can stop kicking the can down the road for the next president and let action take place then this an issue that will forever be reoccurring.
- Jason Rivera

Anthony Riccio said...

At this point it seems that the Republican Party’s reaction to the Affordable Care Act has been spiteful and unwarranted. Perhaps the protesting of the act before it was passed could be justified, but now that it has been made a law there is no excuse for their behavior. Especially absurd is the fact that many Republican controlled states are denying extension of Medicaid eligibility to the working poor when the government is funding most of the costs. The reaction just seems malicious and unjustifiable. Another equally troubling point that the article mentions is that current political decisions are still made through a lens of prejudice. This means that our economy is in the hands of those who may be closed minded and incredibly biased. It’s truly sad that the poor and other minorities are facing discrimination because it is in the self-interest of some political leaders. This really makes it difficult to make our economy efficient, because those in power aren’t concerned with the welfare of us all, but are trying to establish their own agenda. Unfortunately, from observing the points about discrimination of the poor throughout history, it seems to me that the states opposing the health care reforms are simply doing so out of prejudice. They feel they are superior and out of pride they restrict aid to the less fortunate. It is a means of control and as mentioned in the article, they use confusion regarding the complexity of the legislation in order to forward their personal agendas of discrimination. History repeats itself and if we want to ensure the fair and justifiable treatment of all in this scenario, we need to ensure that everyone has equal access to affordable care. If there is opposition to this view I welcome it, but I want verifiable economic evidence as to why affordable health care would be harmful to society, not unwarranted excuses that take advantage of the naive and are simply promoting prejudice.

-Anthony Riccio

Anonymous said...

Racism has been around for centuries. No matter what, we may never really fully escape it. The most progress someone can say is that humans have become more civilized. We no longer linch people based on the color of their skin. We now speculate and judge weather or not an issue or decision is driven by or based off of racist or prejudiced points of views. The article discusses the matter of affordable care in the United States and the lack of concern given to the poorer class of Americans. It is sad that people believe that the race of our President will depict how he or she handles specific ethnic groups in our country. It should have nothing to do with anything and should not be viewed though a racial lens. Everyone who needed it, regardless of color and race, was benefited from what Medicaid provided. Access to affordable health insurance should be considered a civil right for everyone.

-Mitchell Borrero

Anonymous said...

This article highlights a major problem of our federal government that dates back many years. Achieving affordable healthcare for all, no matter what your income or economic status is seems impossible. Extending eligibility for programs such as Medicaid, Medicare and or welfare to the less fortunate people in our country should be a priority and the fact that our government has shut down over it is completely ridiculous. Furthermore, to implement policies such as this nationwide polls should not be conducted and considered in whether or not they will be successful because they are obviously going to be skewed considering all the households with a healthy income will disapprove of the new policies due to the fact that they will not benefit from them in any way. The Government needs to take the matter into their own hands and work together to develop a policy to make healthcare available for all. Now obviously this is easier said then done but for the two parties to disagree to the point where our government has been totally shut down is unacceptable. When it comes to the topic of racial prejudices in politics its something that we need to let go. Times have changed a lot since the beginning of our country and a lot of our political problems and disagreements would be settled a lot easier if we could simply just drop them. Its time to start looking at the big picture instead of being selfish and focusing on only what we will gain or lose from the passing of a new program.

-Michael Scalia

Anonymous said...

Racism and discrimination has been the root cause of many problems that are existent in this world right now. I found one study that is mentioned in the article very unusual and unfair. The study mentions that poor whites are promised protection against labor market competition or higher taxes in return for acquiescence with policies that restrict social safety net. I find this a good bribe, but what about the other races? why is this kind of a bribe only offered to poor whites? I think if we put all the race thing behind us we will eliminate a good deal of problems within our country and worldwide too.
The democrats are not letting the affordable act being implemented because they dont want to pay higher taxes which will benefit the poor. I think this is one of the big reasons why there is unequal distribution of income in United States. Big corporate companies get tax breaks and subsidies by the government while the poor people pay their taxes and part of those taxes end up as subsidies which are given to big corporate companies.
-Asfand Khan

Anonymous said...

race always has been, and always will be a factor in politics. in this article it talks about how some states wont help a population in poverty because they are a certain ethnicity. by being spiteful with their own prejudices, they're hurting the rest of the population. if people aren't able to get help from programs such as medicaid or welfare, then they are just going to fall down further into poverty. this government should work together to help all of its citizens so we all can benefit, instead of pushing us into further problems. by continuing the way they are, and using their personal prejudices to make decisions, they are only lengthening the gap between rich and poor and diminishing the middle class in this country. they are not only diminishing the middle class, it sounds like they are trying to make the white population rich and keep the black population poor. this government needs to work together to bring this country back on track.

-Benny Villani

Anonymous said...

I would say that race does have a part to play in politics. The United States says that it is a country of equality, but everybody knows that that is not the case. Down in the southern states, the state government will pass many laws that prohibit black people from participating in society. It is definitely an every day struggle for the poor class to be able to function well in society when they are constantly being suppressed. Even white people are allowed more rights than black people, simply because they are white. When the racial tension is truly absolved in this country, it will flourish a lot more and more efficiently.

-Benjamin Stark

Anonymous said...

The moral of this article is that racism and money greed has been and still plays a huge role in politics. I do not think Obama is proposing the Act for race purposes alone, but he is trying to better all the working poor, which just happens to be dominated by African Americans. I believe that the Republicans reaction to the Act was a little unnecessary. The United States is not in a position in the world right now where it can have its federal government shut down. Aside from Republicans, I also believe that the all powers of America need to stop worrying about their pockets while they're in power and alive and need to work towards fixing the economy and stabilizing America for decades in time. A way to get America back its "Golden Streets" is to get everybody including the poor at an exceptional financial level. In the end its up to the President and other separate powers to decide the fate of the country.

Alonzo Goffe