Earlier this month, the Trump administration let states impose work requirements on Medicaid recipients. Ten states, all of which have Republican governors, lined up to make it harder for low-income people to get benefits. Kentucky was the first to get approval for the policy.
Only very few working-age Medicaid recipients are able to work and aren’t working. The Kaiser Family Foundation notes that “most nonelderly Medicaid adults already are working or face significant barriers to work, leaving a very small share of adults to whom these policies are directed.” Instead of moving meaningful numbers of Americans into the workforce, the move will only deepen an already massive divide in how states administer their Medicaid programs that was created when the conservative majority on the Supreme Court ruled that states could opt out of the Affordable Care Act’s Medicaid expansion. The states that expanded Medicaid made the program available to everyone making up to 138 percent of the poverty line; in the states that opted out, the median cutoff for eligibility is just 44 percent of the poverty line for families with children. In all but one of those states, people without children are ineligible for benefits no matter how little they earn. An estimated 2.4 million Americans have lost out on public insurance in those 19 states. With work requirements, some of these states will soon provide coverage to an even smaller portion of their low-income population—Kentucky governor Matt Bevin brags that the move will kick 100,000 Kentuckians off the Bluegrass State’s Medicaid rolls.
That same week, a very different story came out of New Jersey, where newly elected governor Phil Murphy was sworn in. Murphy ran on a platform of legalizing pot within his first 100 days in office, raising the Garden State’s minimum wage to $15 per hour, closing its gender pay gap, and rejoining the Regional Greenhouse Gas Initiative that his Republican predecessor ditched in 2011. Now that a Democrat is in the governor’s mansion, the state is entirely controlled by Democrats. Key political figures in the state seem eager to enact major progressive policies. According to The Washington Post, “If Murphy has his way, New Jersey will become a proving ground for every liberal policy idea coming into fashion, from legalized marijuana to a $15 minimum wage, from a ‘millionaire’s tax’ to a virtual bill of rights for undocumented immigrants.”
What’s happening in states like Kentucky and New Jersey is part of a larger trend, as an increasing number of states come under one-party rule at a time when Trump and congressional Republicans are explicitly targeting blue states for punishment and the resistance is both energizing Democrats and holding their elected officials accountable.
To a certain extent, red and blue America have long been divided by different approaches to public policy. Democratic-leaning states tend to spend more on education, health care, and various social services than their red counterparts, and tend to have stronger protections for the environment, workers, vulnerable minorities, etc.
These differences are, to some extent, ameliorated by federal law, which limits the states’ autonomy in several key policy areas and guarantees a degree of conformity among the states. Most education policy, for example, is set by the states, but they have to do so in a way that conforms to various federal laws and regulations. This isn’t news.
But since the election of Barack Obama—and even more so now that Trump and the Republicans essentially own Washington, DC—three factors have come together to dramatically deepen these long-standing divides, and they threaten to undermine the fragile continuity that makes us one country.
First, our tendency to cluster in places with like-minded people combined with a well-funded conservative campaign targeting state governments helped create a huge number of states where one party controls both the governor’s office and the legislature. There are nine more states with unified control of government today than there were as recently as 2010. With New Jersey, Democrats now have eight, the Republicans hold 26 and there are only 16 states where the two major parties share power, according to Ballotpedia.
Rising polarization has raised the stakes of partisan fights. In the post-war era, the two major parties have never been as divided on what are often really core values as they are today.
And, perhaps most importantly, under Trump, and with the efforts of Senate majority leader Mitch McConnell under Obama, Republicans have shattered the norms that held together an often contentious republic. It’s hard to overstate the degree to which the tax bill Republicans passed last month was unprecedented in its specific targeting of Democratic-leaning states with higher state and local taxes for punishment. After the embargo of Obama Supreme Court nominee Merrick Garland, the gloves are coming off.
To varying degrees, the eight states with unified Democratic control of government—home to a quarter of the population—have been passing pro-immigrant legislation, expanding public health-insurance coverage, legalizing marijuana, raising minimum wages, implementing automatic-voter-registration systems, and combating climate change.
They’re making moves to protect their citizens from Trumpism, and they see it that way: Peter Schrag writes that California Democrats are “determined [to] fight, wherever possible, against the cruelty and inanity of an administration and a Republican congressional majority hell-bent on rolling back the programs and policies of enlightened self-interest enacted over the better part of a century under both Republican and Democratic administrations.” California is one of several blue states that are considering various ways to shift from income taxes, deductions for which the GOP plan capped, to payroll taxes or perhaps even charitable donations in order to maintain their deductibility.
Others are considering enacting health-insurance mandates at the state level after the GOP killed the Affordable Care Act’s mandate last month. Oregon voters just approved new taxes to help pay for the Beaver State’s aggressive expansion of Medicaid, which has helped reduce its uninsured rate to 5 percent, one of the lowest in the country.
With the Trump administration rolling back Obama’s overtime rule, which would have given 4 million working people a healthy raise, Democrats are looking to pass a similar measure state-by-blue-state. (Meanwhile, red states are passing laws that prohibit their cities from raising their minimum wages—Missouri went so far as killing an existing minimum-wage ordinance in St. Louis—guaranteeing paid family leave, passing laws to protect the LGBT community against discrimination, environmental rules, and more.)
Republicans want to expand this divide further by block-granting programs like Medicare and Medicaid. It’s not hard to imagine a near future where citizens of red and blues states effectively live in two different countries, with even wider gaps in education and public health, radically different social safety nets, and divergent regulatory regimes.
All of this raises the stakes for this year’s elections, when Republicans will be defending 26 governorships—and unified control of eight battleground states—against what many observers believe will be a Democratic wave election.
It also highlights the importance of the upcoming Census, which will set up redistricting in 2020 and which the Trump regime is trying to game by scaring immigrants into refusing to participate. The Census not only helps determine the shape of Congress for the next decade, but also how trillion of federal dollars will be allocated between the states over that same period (around a third of all federal assistance programs are divvied up between the states according to Census data).
The outcome of these fights will also have a huge influence on voting rights, access to reproductive and other health care, and the degree of social insurance offered by the states. And given the current trend, they may ultimately help determine whether the United States looks like one country with a modern, mixed economy, or two very different republics sharing one set of borders.