SAN FRANCISCO — Former president Barack Obama’s visit to the White House on Tuesday was aimed at reminding anyone willing to listen of the success of the Affordable Care Act that he and President Biden championed.
In his celebrated 2004 Democratic National Convention speech, Obama insisted that “there’s not a liberal America and a conservative America — there’s the United States of America.”
Eighteen years later, red states and blue states are moving further and further away from each other in how they deal with not just health care but a wide range of issues, including voting rights, climate change, guns, abortion, LGBTQ rights and education.
“Political polarization” goes from abstract to evident in the sharp contrast in state choices — and in how entrenched each party is becoming in states that have long leaned their way.
At the extreme, an unbridgeable gap among the states over slavery led to the Civil War. We are not at that point, but we can’t ignore how the hardening of political opinions, especially on the right, as well as the politics of cultural warfare and a series of Supreme Court decisions mean that state boundaries have a growing effect on how people live.
Tuesday’s White House event brought this home. In praising the Affordable Care Act as “the most consequential health-care legislation passed in generations in our country,” Vice President Harris noted that it had expanded health coverage to more than 30 million Americans. She also pointed to the 12 states that have refused to expand Medicaid under the law, leaving 4 million Americans “locked out of coverage.” This number includes 2.2 million who have no pathway to coverage at all.
The “Medicaid gap” was not supposed to happen. Originally, the ACA required all states to expand coverage. But in a move that substantially revised earlier understandings of federal power, the Supreme Court decision that declared Obamacare constitutional struck down the expansion requirement as violating states’ rights. A dozen deeply red states, eight of them in the South, have refused to participate, meaning that for millions of Americans, crossing a state line can deprive them of access to health insurance.
We are also two Americas when it comes to voting, thanks to the Supreme Court’s gutting of the Voting Rights Act. As of December, 19 states had enacted restrictions on ballot access even as 25 states expanded it, according to a Brennan Center for Justice tally.
And on abortion, the story is comparable. The Supreme Court’s tilt toward states’ rights could become sharper in an abortion decision expected later this year. Already, the court’s inclinations have called forth a burst of more restrictive laws in red states (see Oklahoma this week) and legislative guarantees of abortion rights in blue states.
The covid-19 pandemic has also shown how state divides have become matters of life and death. In his State of the State message last month, California’s Democratic governor, Gavin Newsom, openly contrasted his state’s policies and health outcomes with those of three Republican-led states. He was especially pointed about the record in Florida, where Republican Gov. Ron DeSantis has waged war on vaccine and mask mandates.
“Our lockdowns, distressing as they were, saved lives,” Newsom said. “Our mask mandates saved lives. Your choices saved lives. California experienced far lower covid death rates than any other large state. Fewer than Texas, Ohio, fewer than Florida — 35 percent to be exact.”
Newsom spoke with pride about California’s liberal-leaning leadership, especially on climate issues. He repeatedly touted “the California Way” that rejected “exploiting division with performative politics and memes of the moment.” It was hard not to think that Newsom was laying out themes for a future presidential campaign.
It’s true that our system of federalism encourages useful experiments state-to-state that can pioneer new ways of solving problems. But the increasingly radical divergences threaten national cohesion and coherent policymaking on climate, covid and health care, and more. Neither the coronavirus nor the atmosphere recognizes state boundaries.
The political writer Ron Brownstein, who has paid close attention to the impact of the growing divide, warned in the Atlantic in December of “a dramatic erosion of common national rights and a widening gulf — a ‘great divergence’ — between the liberties of Americans in blue states and those in red states.”
It’s hard to see any politician gaining much traction by launching a new national debate over what federalism should mean in 2022. But our ability to govern ourselves depends on facing up to the consequences of what is fast becoming an unsustainable approach to states’ rights.