Trapped in America's Safety Net

When Andrea Louise Campbell's sister-in-law, Marcella Wagner, was run off the freeway by a hit-and-run driver, she was left paralyzed from the chest down. Like so many Americans-50 million, or one sixth of the country's population-neither Marcella nor her husband, Dave, had health insurance. On the day of the accident, she was on her way to class for the nursing program through which she hoped to secure one of the few remaining jobs in the area with the promise of employer-provided insurance. Instead, the accident plunged the young family into the tangled web of means-tested social assistance. As a social policy scholar, Campbell thought she knew a lot about means-tested assistance programs. What she quickly learned was that missing from most government manuals and scholarly analyses was an understanding of how these programs actually affect the lives of the people who depend on them. Using Marcella and Dave's situation as a case in point, she reveals the system's many shortcomings in Trapped in America's Safety Net.Because American safety net programs are designed for the poor, Marcella and Dave first had to spend down their assets and drop their income to near-poverty level before qualifying for help. To remain eligible, they will have to stay under these strictures for the rest of their lives, meaning they are barred from doing many of the things middle-class families are encouraged to do, such as save for retirement. And, while Marcella and Dave's story is tragic, the financial precariousness they endured even before the accident is all too common in America. Obamacare has reduced some of the disparities in coverage, but it continues to leave too many people open to tremendous risk. Beyond the ideological battles are human beings whose lives are stunted by policies that purport to help them. In showing how and why this happens, Trapped in America's Safety Net offers a way to change it.

"This is a remarkable, astonishing book, at once a comprehensive reference on the American social welfare system and an engaging narrative account of how social assistance programs shape real people's lives. Campbell is authoritative and scholarly, yet warm and personal-a rare combination one sees in the likes of Oliver Sacks and Barbara Ehrenreich." (Deborah A. Stone, Dartmouth College)"

Andrea Louise Campbell is professor of political science at the Massachusetts Institute of Technology. She is the author of How Policies Make Citizens.