EDITOR’S NOTE: This article is part of The Nation’s special issue on Barack Obama’s presidency, available in full here.
Any history of black people in America will have to look closely at the year 2014. In a cascading series of events that summer, the racial landscape that the nation’s first black president leaves behind—the worst and the best of it—began to take shape. Historians won’t have to look hard to find the worst: On July 17, Eric Garner died after a New York Police Department officer put him in an illegal choke hold. Three weeks later, a policeman in Ferguson, Missouri, killed Michael Brown. Black death has led the news ever since—from Freddie Gray in Baltimore to Sandra Bland in Texas to Tamir Rice in Cleveland. Today, Confederate battle flags fly over victory rallies for the president-elect, a man who campaigned on restoring respect for law and order in the face of those who protested that these lives mattered.
But historians will have to look more closely for evidence of what is arguably Obama’s signature contribution to racial equity in America—one that may not even exist a year from now. There are no familiar names to shorthand this achievement, but here’s one that could work: Robert Woodard, a middle-aged black man I met in the lobby of Newark’s Beth Israel Hospital in April of 2014. He was in a jocular mood, eager to make friends with total strangers and full of the kind of hope that Obama often inspires. Robert told me his best guess is that he had his first heart attack in 2003. He knows he survived seven more after that, because he has the bills to remind him. “All I do when I get them bills…I just stack it,” he said.
Robert is a New Jersey native, but he’d spent most of the last 30 years in North Carolina, where he worked in a convenience store without any health insurance. After each heart attack, he left the emergency room and went back to work instead of going to see a doctor. He was stuck in a catch-22 familiar to the working poor: If he quit his job, he’d qualify for disability and thus for public health insurance, but North Carolina’s paltry disability benefits weren’t enough to support him. So he kept working, even without insurance—and kept having heart attacks. That was his life for more than a decade, and by the time his brother convinced him to move back home, he needed major heart surgery. Luckily for Robert, soon after his return to New Jersey, the Affordable Care Act’s expansion of Medicaid kicked in, at least in the 32 states that have been willing to participate thus far. North Carolina wasn’t among them; New Jersey was, and that meant Robert could afford a new heart.
Neither President Obama nor his detractors saw political advantage in discussing the Affordable Care Act as an antipoverty or racial-justice program, but it is both of these things, and among the most ambitious versions of either since the Johnson administration. Between the January 2014 launch of new coverage options and Michael Brown’s death that August, the nation’s public-insurance program for the working poor grew by roughly 7 million people. As of this summer, it had gone up by more than 10 million. The Affordable Care Act overall has likely saved hundreds of thousands of black lives, and it has certainly produced one of the most significant advances in racial equity on record: By the end of 2014, in just one year’s time, it had entirely erased the disparity in health coverage between white and black kids.