I recently learned that states confer citizenship. Either I really wasn’t paying attention during that Senior-year government class in 1992 (could be), or I was never taught this in school! It is a surprise to me! And reinforces the slowly-dawning realization that my fandom of the Federal Government might be influenced by the fact I’ve spent most of my life as a government beneficiary. I have been saying it more often: I am a beneficiary of the Federal Government. Born at a U.S. Navy hospital. The bill for my birth: a couple of bucks for my Mom’s meals during our hospital stay.
I wasn’t even born here. The only government entity that has certified my birth is the State Department. That’s the U.S. State Department. I am a Citizen of the United States. All of them, I always figured. I’ve lived in a few states… California, Virginia (shudder), Massachusetts, Vermont, Montana, Hawaii, Washington, Oregon, Texas, South Carolina, Maryland, and then an August in Georgia (thanks, Army!). Those are the states I’ve lived or worked in; adding in the ones I’ve spent time in or driven through, brings us up to about 45 of the lower 48 (I don’t count airport layovers). This isn’t a brag, I just always focused on the “united” in the name of our country: I drift from state to state as though they’re all part of one place. Because I don’t have a home state, they’re all mine. Ours.
Turns out that isn’t everyone’s perspective. I learned more about State’s Rights last semester than I ever thought I could. And though I understand how it works, and the historical context and all that jazz, I don’t *get* it. States really want to be in charge of everything, including health, with little or no interference from the Federal Government. A frequent response to proposed public health or other social policy from the Fed is something like “States know what’s best for their people.” They don’t need or want Big Government telling them what citizens of (state) need or how to go about providing it. I would buy that response, if there weren’t
22 18 states refusing to expand Medicaid right now. They are choosing to leave the people of their state (or Commonwealth, Virginia) uninsured and with no access to affordable health insurance or healthcare. How is that best?
It’s not just Medicaid expansion; it’s mental health, food assistance, housing, welfare, education, and infrastructure. States are responsible for these social services, but have cut funding or insist on adding hurdles between people without, and the food, housing, and healthcare they need. In the case of rejecting Medicaid expansion, that means refusing funds from the FedGov, as in “no thank you, Federal Government, we don’t want that Billion dollars.” And because each state decides what is best, there’s a difference between being poor in D.C.* and being poor in Virginia or Alabama or Michigan. I wandered across this handy chart from Kaiser Family Foundation that breaks down state spending by category. You can see which state spends more on corrections than on education, and which states spend more on corrections than on public assistance.
This post will be the first in a series exploring each area of need and how benefits vary from state-to-state, and how the states and FedGov share those responsibilities.
*okay, you got me: D.C. isn’t a state. (Yet.) But the District works hard to provide more for its residents than its neighbor Virginia does.