“Expanding Medicaid could help a lot, but these states just don’t do it,” Braga told us. “And they don’t realize how much of an impact that actually has on people’s lives and their financial well-being — even access to employment.
Fuckin' LOL of course they goddamn realize it. Wealth was a proxy for breeding long before slavery was abolished and became absolutely entrenched during Reconstruction. It's pretty funny if you look up "wigger" on UrbanDictionary because the people who remember aren't gonna tell ya? But it's the term Southern elitists used to describe white people who are honorary members of the African-American race due to their (lack-of) income, (lack-of) resources and (lack-of) breeding. I'll say this for the south - they integrated more than most people realize, it's just that black people can never be white. White people? Yeah they can for sure be treated as black.
There's a reason the South cares so fucking much more about "tradition" - it reinforces a striated culture of haves and have-nots. The North was colonized by religious extremists and rebels while the South was colonized by mercantilists. The North became a place that was brutal to everyone while the South became a place that took care of nobility at the expense of the chattel. Northern tradition is whatever your grandfather did; Southern tradition is whatever your grandfather's grandfather's grandfather did - because if you had any resources you sought greener pastures and you aren't a Southerner anymore.
The people running for office, the people applying law and the people distributing resources aren't on goddamn Medicare and they know it and if you're in trouble your church will sort your shit out, not the state, because your church can determine whether or not you deserve it. State's gotta give money out to everyone, especially "welfare queens".
The cruelty is the point.