When President Obama leaves office there will almost certainly be efforts to ascertain the impact of our first black president on the black community. Defenders of the president's record will likely point to Obamacare as the kind of program that expanded the safety net for everyone but specifically for those in need -- a class in which African Americans are overly represented. 

I have, of late, been anxious to add an asterisk to this accolade. As I've noted before, black people are also disproportionately represented in many of the states which are refusing the Medicaid expansion. Thus the idea that Obama has aided poor black people through a broad race-blind expansion of the social safety net deserves some scrutiny.

This morning the New York Times offers us just that:
A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times...

The 26 states that have rejected the Medicaid expansion are home to about half of the country's population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country's uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses' aides.

Blacks are disproportionately affected, largely because more of them are poor and living in Southern states. In all, 6 out of 10 blacks live in the states not expanding Medicaid. In Mississippi, 56 percent of all poor and uninsured adults are black, though they account for just 38 percent of the population.

Dr. Aaron Shirley, a physician who has worked for better health care for blacks in Mississippi, said that the history of segregation and violence against blacks still informs the way people see one another, particularly in the South, making some whites reluctant to support programs that they believe benefit blacks....

Dr. Shirley said: "If you look at the history of Mississippi, politicians have used race to oppose minimum wage, Head Start, all these social programs. It's a tactic that appeals to people who would rather suffer themselves than see a black person benefit."
Indeed. Liberals who believe they can fool racists by changing the subject from racism to class underestimate the intelligence of their audience. "All that it would take to sink a new WPA program would be some skillfully packaged footage of black men leaning on shovels smoking cigarettes," writes sociologist Douglass Massey. "Papering over the issue of race makes for bad social theory, bad research and bad public policy." 
 
To say nothing of morality. Because we live in a segregated country, the people who must bear the burden of the uninsured black poor will ultimately be other black people. This is not just a matter of individual black people not having insurance. It is a shock to the entire system, the entire network of black people who -- because of white supremacy -- live segregated lives, and must bear this on their own.
 
More later. If you've been reading me the past few months, you know that I am wholly unsurprised.

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