May 8, 2025

“We can all thrive. We can all live lives of meaning and dignity, and the key to our thriving is found in our community.” 

This reflection from Kamilah Pickett, Director of Race Matters Institute at MDC, captures the essence of the 2025 State of the South Report. In May 2025, MDC hosted a series of webinars diving into the report’s themes of Meaning, Dignity, and Community and associated recommendations for action. We were joined by community partners, report authors, and MDC staff to help us break down these themes and how they are playing out in Southerners’ lives today. Couldn’t make the webinars? Read on for our recap of the conversation on Meaning below.  

MEANING 

On May 8, Cate Elander, State of the South Program Director, was joined by report contributors Jenny Fine, Jenna Bryant, and Amit Khanduri to discuss the Meaning section of the report. MDC defines meaning as “Southerners’ ability to envision and shape their own best futures”. To us, this manifests in issues like Medicaid expansion, student loan debt, wage inequality, baby bonds, and more.  

Medicaid Expansion 

Jenny Fine, a visual artist living in New Brockton, AL, shared the powerful story of her sister Beth’s journey with Medicaid. In Alabama, about 1 out of every 5 Alabamians (1,097,000 children and adults) depend on Medicaid for health insurance, and 92,000 adults in Alabama are currently ineligible for Medicaid but would be covered if the state chose to expand Medicaid. Across the 13 Southern states, six states (AR, KY, LA, NC, VA, WV) have expanded Medicaid so far while seven (AL, FL, GA, MS, SC, TN, TX) continue to withhold coverage.  

The Medicaid expansion changes passed in H.R. 1, also known as the “One Big, Beautiful Bill”, will cause three Southern states to roll back Medicaid expansion coverage even further: Arkansas, North Carolina, and Virginia have trigger laws requiring them to terminate Medicaid expansion if the federal matching rate drops. Additionally, instituting work requirements for Medicaid recipients will likely result in millions of working people losing coverage due to the administrative burden of reporting requirements. About 64% of Medicaid recipients are working full- or part-time jobs, and 29% are not working due to caregiving responsibilities, school attendance, or illness or disability. In Arkansas, a nine-month imposition of work requirements from June 2018-March 2019 resulted in over 18,000 people losing coverage, about 25% of the population subject to the requirement, largely due to challenges they experienced with documenting their work status or exemption eligibility. Learn more about Medicaid work requirements and the predicted impact of federal Medicaid spending reductions.

Economic Mobility 

Jenna Bryant, Senior Program Director for Economic Security & Mobility at MDC, echoed the importance of care. MDC’s Economic Security and Mobility team is working on integrated services delivery systems, giving people access to multiple support systems from one entry point. Having the resources and flexibility to meet a need is key to improving economic security and mobility.   

Barriers to economic security and mobility include student debt and medical debt. In the South, around 15,213,300 borrowers hold $458.7 billion in student debt. Between 12-15% of each Southern state’s population holds student debt. This debt is concentrated among people under age 35, who constitute approximately 45-51% of borrowers in each Southern state, restricting their ability to buy homes and invest in their futures. Student loan debt also disproportionately impacts people of color: nationally, Black and African American college graduates owe an average of $25,000 more in student loan debt than white college graduates. Medical debt is also a huge problem: American adults collectively owe at least $220 billion in medical debt. On average, between 9% and 15% of adults in each Southern state hold medical debt. The burden of medical debt is also worse for people of color: 13% of Black adults hold medical debt, compared to 8% of Hispanic adults, 7% of white adults, and 3% of Asian adults. The presence of this debt holds people back from pursuing new opportunities, caring for their families, and building the lives that they choose. Eliminating systemic barriers to building wealth and accessing healthcare is necessary for Southerners to build a safety net and advance economically.  

“We want people to be able to weather a crisis. We know that people may bend during times of uncertainty, but we won’t want them to break. We want them to be able to care for their families, to plan or their futures, and really be able to participate in their community however they see fit.” – Jenna Bryant 

Wealth Gap Solutions 

Amit Khanduri, Director of Programs at the Georgia Resilience and Opportunity Fund, shared some insight with us on the persistence of the racial wealth gap and some policies that could help close the gap. The racial wealth divide is 46:1 in Atlanta, GA; 47:1 in Houston, TX; and 87:1 in Greensboro, NC. The racial wealth divide in these cities is as high or higher than the national racial wealth divide in 1863, just after Emancipation.  

Opportunities to shrink this gap include guaranteed income and baby bonds (child trust accounts). Guaranteed income programs offer unconditional cash payments to a targeted community, usually with specific needs, designed to raise the minimum income standard. Interest in this concept is growing, with at least 163 recent pilot programs being tested across the United States, including at least 24 in the South.  

“A guaranteed income provides unrestricted cash payments typically on a monthly basis to folks who are living in poverty, and it’s designed to provide an income floor, provide a bit of breathing room for folks so that they can meet their basic needs and also. . . plan for the future.” – Amit Khanduri 

The North Carolina legislature is currently considering a bill that would bar NC cities and counties from adopting or enforcing guaranteed income programs. Learn more.  

If baby bonds were to be implemented, every child born in a participating place (city, county, state, or federal level) would automatically receive a government-funded savings account which would be managed by federal, state, or local governments until adulthood. The seed deposits can be income-dependent so that lower-income families receive larger deposits, and when the children reach adulthood, they can use their funds to pay for higher education, homeownership, or entrepreneurship. A baby bonds program would be an investment in the American people and a step towards leveling the country’s ever-persistent racial wealth gap, as these funds would allow future generations access to capital and opportunity, regardless of their background. 

 Conclusion 

We concluded the Meaning webinar by lifting up the recommendations from the Call to Action section of the 2025 State of the South Report, including the opportunities shared from our speakers around Medicaid expansion, guaranteed income, and baby bonds. To learn more and get involved, check out the Call to Action, and let us know how you’d like to join us in the work to build a thriving South.  

• Download our Webinar Resource Guide (links to data, research, and narratives about the issues) 

• Watch our Webinar Highlight Reel (covering key data, report author perspectives, and what we can do next)  

ABOUT STATE OF THE SOUTH 

MDC’s State of the South program aims to build knowledge and collective power in the South by forging and deepening connections between communities, artists, nonprofit leaders, policy makers, and funders working on shared issues. We do this by sharing regional data and amplifying effective policies and strategies, hosting issue-focused convenings across the region, and investing in Southern art and storytelling.  

Read the 2025 State of the South Report. To get connected with State of the South, reach out to Cate Elander, State of the South Program Director, at [email protected].