Righting Historic Wrongs: An Opportunity for Southern States in the Face of COVID-19

The evidence continues to mount: for Southern states, COVID-19 will be particularly devastating. The effects of the pandemic are only beginning to take shape but are already shining a harsh and unflattering light on the structural racism and economic inequity embedded in our country. Due to unfair and discriminatory health and economic barriers, Black people are more likely to have the chronic illnesses and underlying health conditions that put people at greater risk if they do get sick from COVID-19.  

Additionally, people of color disproportionately work in frontline industry jobs – from grocery stores to cleaning services to public transit – that put them at greater risk of being exposed to the virus. With 58% of African Americans living in the South, this means we will see a disproportionate number of Black people harmed. Years of erosion to Southern health infrastructure, especially in rural areas, means less access to health care and high uninsured rates that again disproportionately affect people of color. This confluence of factors means that Southern states have an imperative to act now to change course and stem further damage to these communities.  

What we have seen from the virus’ trajectory so far is cause for concern. While some states acted early and shuttered businesses and ordered folks to stay home, states like Alabama, Florida and Georgia were slow to act and even once they did, were not resolute in their decisions. This is all exacerbated by an already vulnerable and ill-equipped health care system that was not designed to handle the potential influx of patients that might end up needing care in the face of a pandemic.  

This is a perfect storm waiting to break – but it doesn’t have to be. States can take actions now that will not only better prepare them to handle any COVID-related needs but also start addressing and dismantling barriers that have disproportionately harmed people of color.  

The biggest bang-for-your-buck solution is Medicaid Expansion. Unsurprisingly, 9 of the 14 remaining non-expansion states rest in the South. These are states with traditionally high numbers of uninsured individuals, struggling hospitals and weak safety-net supports. Expanding Medicaid would bring a much-needed infusion of federal dollars into these states, bolstering their health care infrastructure, paying providers and strengthening local economies and communities.  

Many health advocates in these states have long been pushing for expansion and have renewed their calls in light of the current pandemic. Editorial pages in Texas and Florida have evoked strong calls for expansion, and states like these and North Carolina have worked in partnership with other advocates and stakeholders to submit letters to their governors, requesting expansion now.  

While Medicaid expansion is not a silver bullet, it is irresponsible for states not to take immediate actions within their control, such as expanding Medicaid, which could alleviate the burden and narrow inequities. Now is the time for Southern states to act fast to protect their residents. To stem the virus’ impact, we must give everyone a fair shot at getting through the crisis healthy and whole, and that means ensuring the South does not get left behind.