Racial Framing Drives Opposition to Healthcare Redistribution, Study Finds

University of Delaware political scientists Sumeyye Mine Iltekin Gocer and Joanne M. Miller surveyed over 700 white Americans. When respondents first compared white Americans to Black and brown Americans, they rejected food-stamp, Medicaid, and other redistribution programs, even when personally beneficial. The authors conclude racial framing suppresses support for health-care expansion.

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President Lyndon B. Johnson warned in 1960 that convincing white voters of superiority secures their financial support. Deregulation under President Reagan later turned nonprofit hospitals and insurers into for-profit enterprises, creating a market where health care generates private wealth.

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Becker’s Hospital Review identified 51 health-care billionaires, including hospital-chain heir Thomas Frist Jr. ($41 billion) and medical-device families the Cooks and the Strykers. Seven former Confederate states—Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, Texas—have declined Medicaid expansion, forgoing billions in federal funds. Those states record the nation’s worst health metrics: Tennessee’s maternal mortality is 42.1 per 100,000 live births; Mississippi’s infant mortality is 9.7 per 1,000; and Mississippi’s life expectancy is about 71 years, the lowest in the United States.

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Senators Bernie Sanders, Rep. Pramila Jayapal, and Rep. Debbie Dingell sponsor a Medicare-for-All bill with hundreds of co-sponsors and backing from National Nurses United and organized labor. California is preparing a billionaire wealth tax to fund health care and education. Republican officials and donors, including former Senator Rick Scott—whose company was found responsible for the largest Medicare fraud case—continue to oppose expansion.

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The Delaware study relies on self-reported attitudes from 700 white respondents and does not include comparable data from other racial or ethnic groups, nor does it directly link attitudes to voting behavior or health outcomes.

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• “he won’t notice you picking his pocket. H---, give him somebody to look down on, and he’ll empty his pockets for you.” — Lyndon B. Johnson, 1960

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• “The people who’d benefit most from a national healthcare system are the people who keep voting against it.” — Author of the article

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• “Convince a guy in Tupelo that Medicaid expansion is a handout to Black people in Jackson, and he’ll vote to keep his own daughter uninsured.” — Author of the article

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• “The only thing missing is enough Americans willing to recognize the con LBJ named sixty-six years ago and refuse, just once, to fall for it.” — Author of the article

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Congress will debate the Medicare-for-All bill in the coming months, and California’s wealth-tax ballot measure is slated for the November election. Researchers plan broader surveys to test the study’s findings across diverse populations.

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