The 1619 Project: A New Origin Story

“Unbought, Unbossed, Unbothered” fiction by Nafissa Thompson-Spires

“Crazy When You Smile” poem by Patricia Smith

Healthcare in America has always been a commodity that depends on a range of factors, such as “age, income level, employment status, geographic region, and—to an alarming rate—race” (388). When the Affordable Care Act passed during Obama’s Presidency, it was, as Biden said, “A big fucking deal” (388). The ACA made healthcare more accessible, but it has also been one of the most challenged policies in contemporary politics.

After the Civil War, there was a crisis: Freed people had nothing, and many were suffering from disease. The government created the Freedmen’s Bureau to support the recently freed, but there was disagreement about how it should be run and what its responsibilities should be. Some argued that help would “breed dependence,” while others suggested that the illnesses Black people were experiencing was simply nature taking its course and that Black people were not suited for freedom (391). In 1945, the hospital system expanded, but the legislation that created this expansion excluded Black Americans and would have long-lasting implications.

After World War II, employer-based insurance was introduced, conveniently leaving out Black Americans, who were denied the jobs that provided insurance. Further segregation kept Black doctors from joining professional organizations, medical schools, and most hospitals and health clinics.