Slavery’s Long Shadow
Its authors — who are not, by the way, especially liberal — explored a number of hypotheses, but eventually concluded that race is central, because in America programs that help the needy are all too often seen as programs that help Those People: “Within the United States, race is the single most important predictor of support for welfare. America’s troubled race relations are clearly a major reason for the absence of an American welfare state.”
.. And what do these states have in common? Mainly, a history of slaveholding: Only one former member of the Confederacy has expanded Medicaid, and while a few Northern states are also part of the movement, more than 80 percent of the population in Medicaid-refusing America lives in states that practiced slavery before the Civil War.
And it’s not just health reform: a history of slavery is a strong predictor of everything from gun control (or rather its absence), to low minimum wages and hostility to unions, to tax policy.