If Kamala Harris wins Tuesday’s election, Alabama will have a champion in the White House for policies that matter in a state plagued by poverty, limited access to medical care, and chronic health problems, Democratic leaders working to elect the vice president say.

A Harris administration would promote solutions needed for a state that relies on federal dollars more than most, the Democrats say.

“I think it’s unfortunate at times that some Alabamians end up voting against their own interests,” said state Sen. Merika Coleman of Pleasant Grove, chair of Alabama’s Legislative Black Caucus. “And that’s just because of the partisanship.

See also: What would a Trump presidency mean for Alabama?

“Alabama, when you look at us nationally, we are considered a poorer state. We are a receiver state, not a donor state. So we get lots of money from the federal government.”

The ratio of federal spending vs. federal taxes paid per person in Alabama is about two-to-one, one of the highest in the nation, according to the Rockefeller Institute.

According to the Alabama Kids Count Data Book 2023, published by VOICES for Alabama Children and the Annie E. Casey Foundation, more than one-fifth of Alabama children live in poverty.

Harris is advocating for policies that Democrats say will help families, like an expanded child tax credit, down payment assistance for first-time homebuyers, increased tax benefits for new businesses, and incentives for states to expand Medicaid.

“She‘s articulating actual policies that will make a difference to Alabamians, like having an opportunity economy that works for everyone,” said Congresswoman Terri Sewell of Birmingham, the only Democrat and only Black member of Alabama’s congressional delegation.

“That doesn’t leave folks behind. It’s not about surviving but thriving.”

Medicaid expansion?

Alabama is one of 10 states that have not expanded Medicaid under the Affordable Care Act, a move that would extend health care coverage to several hundred thousand people.

It would be up to the governor and the Legislature to approve expansion. But advocates in the White House and Congress can make that more likely, Coleman said.

“Any type of incentive that could be help us to be able to expand Medicaid in the state of Alabama would be helpful,” said Coleman, who has campaigned for Harris in Georgia and Pennsylvania, two of the swing states that will help decide the election.

“We’ve got some places in our state that don’t have access to maternity wards at all, and other emergency services.”

A report released last year showed Alabama had the nation’s highest rate of maternal mortality, or mothers dying from pregnancy-related causes. Alabama’s rate was almost double the national rate, and the rate for Black women was substantially higher.

“(Harris) is focusing on improving access to healthcare to women of color and poor communities,” Coleman said. “Expanded Medicaid and maternal healthcare and mortality rates, they go hand-in-hand.”

Twenty-five Alabama counties do not offer obstetric care, according to the Kids Count Data Book. More than one-fourth of women in Alabama do not live within 30 minutes of a birthing hospital.

Alabama’s infant mortality rate is well above the national rate and higher for Black babies.

Life expectancy in Alabama ranked 48th among states in 2020, according to the National Center for Health Statistics.

A divided Congress

Coleman says other Harris policies that would help Alabama families include an increase in the minimum wage, tax credits for small businesses, more federal support for HBCUs and public colleges, and a bill to strengthen the Voting Rights Act, Coleman said.

A key factor in enacting federal policies that will help Alabama, Coleman said, is whether Democrats can maintain a majority in the Senate and win control of the House, where Republicans hold a slim majority.

“I think it has to be more than just a Harris presidency,” Coleman said. “I think we also have to ensure, and of course, I’m speaking as a partisan, that the Democrats keep the U.S. Senate and also flip the House of Representatives.

“Then you give her a Congress that will pass legislation that will benefit a state like Alabama.”

Going into Tuesday’s election, Democrats narrowly control the Senate, 51-49, while Republicans hold a slim majority in the House, 220-212.

Jess Brown, retired political science professor from Athens State University, said he believes control of the two houses of Congress will have more effect on Alabama than who wins the White House.

“When you move outside the realm of what a president can do via executive orders or can do via appointments, I think the next president, be it Trump or Harris, is going to once again encounter a bitterly divided and narrowly divided Congress,” Brown said.

“It’s going to be extremely difficult to really even get anything through the House. I think that potentially is going to be a problem. I think if the Democrats get it, they’ll have a majority by a token number of seats. And if Republicans get it they’ll have a majority by a token number.”

Brown sees Harris as the candidate who would be more likely to seek ways to navigate through the Congressional logjam on, for example, issues like promoting Medicaid expansion.

“Harris is more likely to try to at least initially build some bipartisan bridges,” Brown said. “Find some Republicans who might vote for bill A or bill B that she would support.”

“I can’t see Trump nurturing Medicaid expansion,” Brown said. “Whereas her administration would be more sympathetic to doing that.”

‘Lifting folks out of poverty’

Sewell said Harris has ideas that will resonate in households in her district in west Alabama and across the state.

Harris proposes a tax credit for families of up to $3,600 per child, reinstating an idea adopted temporarily during the pandemic.

“We only were able to do it for one year,” said Sewell, who was a sponsor of the tax credit as a member of the Ways and Means Committee. “But we saw we were lifting folks out of poverty. And definitely, children in our district benefitted from it.”

Sewell is a sponsor of the John Lewis Voting Rights Advancement Act, named after the Alabama native and longtime Georgia congressman.

It would restore a requirement for states to receive preclearance from the Justice Department for changes made to voting laws and election procedures, a requirement in the Voting Rights Act of 1965 that was removed by the U.S. Supreme Court in a 2013 Alabama case, Shelby County v. Holder.

“The history of my district is a very proud history of civil rights and voting rights,” Sewell, a Selma native, said.

“And I do believe that during her first 100 days that she would seek to fully restore the Voting Rights Act of 1965, which frankly, would make it easier for all Americans to vote. The vote is the bedrock of our democracy. And states should be seeking ways to make it easier for Americans to vote and not harder.”

Sewell said an example of why the John Lewis bill is needed is a law passed by Alabama‘s Republican-controlled Legislature that made it a felony to pay someone or receive payment to order, obtain, fill out, or deliver another voter’s absentee ballot application.

A federal court has blocked a portion of the law affecting voters who are blind, disabled, or cannot read.

“While I do believe that it’s totally within the state’s purview to administer elections, I do believe the lack of federal oversight when states go awry and amok needs to be restored,” Sewell said.

“I look forward to being able to pass that bill under a Harris administration and make it easier for Americans to vote.”