America's Failing Safety Net

Dear Readers and Subscribes,

This in-depth article is the result of a collaborative effort between Oh. About That... and , combining investigative rigor with personal insight to examine the dismantling of the U.S. social safety net. Drawing on both policy analysis and lived experience, this piece offers a panoramic view of America’s welfare state; its contradictions, global implications, and the human stories too often left behind.

The term “social safety net” in the United States evokes a complex and often contested array of federal, state, and local programs aimed at assisting Americans facing economic hardship. Unlike many European and East Asian countries, which have centralized, universal welfare systems, the U.S. relies on a fragmented, means-tested, and conditional patchwork of programs. This patchwork includes:

Collectively, these programs form what is commonly called the U.S. social safety net. However, many experts argue it is better characterized as a “patchwork quilt with holes,” where millions of vulnerable Americans fall through persistent gaps.

One of the most glaring examples of systemic failure is the experience of applicants for Social Security Disability Insurance (SSDI). The majority are denied at initial application, with only a fraction granted benefits upon reconsideration, an often lengthy process lasting three to six months, itself delayed by an initial six-month waiting period before benefits begin. Those fortunate enough to be approved face a gap in income lasting many months, sometimes years, with back pay disbursed only after lengthy legal procedures. As one Social Security attorney explained, their fees are directly tied to the amount of back pay clients receive, creating a financial incentive linked to prolonged claim processes.

The decentralized nature of welfare administration, often delegated to individual states, has resulted in significant disparities in program availability and quality nationwide. According to the Center on Budget and Policy Priorities, “Access to vital safety net programs varies drastically depending on where you live.”

Bureaucratic complexity, stigma surrounding public assistance, and insufficient outreach contribute to eligible individuals failing to access benefits. Furthermore, some states are incentivized to minimize program enrollment, reflecting a political culture that often stigmatizes recipients as “lazy” or “undeserving,” despite extensive evidence that poverty is linked to structural economic forces beyond individual control.

Since the Reagan era, neoliberal policy reforms have shifted responsibility from the federal government to states and individuals, with an emphasis on “personal responsibility.” This shift has drastically reduced the reach of programs like TANF, which now assists fewer than 25% of poor families, down from over 70% in the 1990s.

TANF’s structure as a block grant encourages states to impose strict time limits and eligibility criteria. As a result, families in crisis increasingly rely on overwhelmed charities and community organizations for basic needs like food and shelter, raising concerns about the erosion of public welfare responsibilities.

Unlike other developed nations, the United States lacks a universal healthcare system. Medical debt remains the leading cause of personal bankruptcy—a fact frequently highlighted by international observers.

Accessing Medicaid or other programs is often a burdensome process involving exhaustive paperwork, asset verification, and stringent deadlines. Health insurance coverage has improved since the Affordable Care Act’s Medicaid expansion, but recent legislative changes threaten to reverse much of this progress. Projections estimate up to 14 million Americans could lose Medicaid coverage within a decade due to policy rollbacks, pushing many back into high-deductible plans with caps as low as $2,500 annually. For millions, this translates into deferred care and worsened health outcomes.

Notably, dental care, a critical but often overlooked aspect of health, is largely excluded from Medicare and poorly covered even in employer plans, with untreated dental issues contributing to serious chronic diseases like heart disease.

Despite rising national wealth, wages for the bottom 50% of workers have stagnated for decades. The U.S. safety net operates reactively, stepping in after crises but failing to provide a stable foundation.

The COVID-19 pandemic exposed the weaknesses of this model. Long wait times for emergency care, shortages of social services, and overwhelmed hospitals highlighted the system’s fragility, with many Americans suffering or dying due to inadequate access.

The United States faces some of the highest urban homelessness rates among developed countries. This crisis stems from a shortage of affordable housing, rising rents, and insufficient government support.

Firsthand accounts from small Midwestern college towns reveal stark realities: people forced to seek shelter in public bandstands during summer heat, with little access to hygiene facilities, and turned away from food pantries due to arbitrary restrictions.

While these systemic issues are well-documented domestically, foreign narratives offer additional insights, often leveraged as instruments in the broader geopolitical information environment.

State-affiliated Russian media outlets such as RT and Sputnik frame the U.S. safety net primarily as a mechanism of social control rather than compassion.

They emphasize:

Former Russian Prime Minister Dmitry Medvedev summarized this viewpoint bluntly:

This perspective also notes entrenched insurance industry opposition to universal healthcare, pointing out that profits from firms like United Healthcare could theoretically fund cancer care for all Americans.

Chinese state media, including Xinhua and Global Times, critique the U.S. through a different lens, focusing on:

A poignant case frequently cited involves a Chinese immigrant in Missouri who died of cancer after Medicaid denied coverage on technical grounds, leaving his young family bereft.

The COVID-19 pandemic is frequently framed as a litmus test exposing American state capacity weaknesses compared to China’s swift, centralized response. Chinese analysts contrast their “common prosperity” policies with what they term American “disintegration” warning that ongoing social disinvestment will exacerbate internal divisions.

In recent legislative developments, the so-called “Big Beautiful Bill” (officially “The American Renewal and Prosperity Act”) has codified a vision of welfare restructuring combining economic nationalism, austerity, and decentralization. Key features include:

The bill’s work requirements echo 1990s policies but lack accommodations for today’s labor market realities. Many gig economy workers, often dependent on unstable, low-wage jobs such as food delivery or rideshare driving, face denial of benefits despite working long hours. Complex tax rules regarding vehicle use and lack of worker protections exacerbate their precariousness.

Shifting federal funds to block grants gives states wide latitude, often resulting in reduced access and services, especially in politically conservative regions. Examples of misappropriation have surfaced, such as welfare funds diverted to sports facilities in Mississippi, raising questions about oversight and accountability.

Replacing cash assistance with app-based “Prosperity Vouchers” managed by corporate partners (e.g., PayPal, Walmart) introduces new layers of surveillance and control over recipients’ spending. This system binds beneficiaries to specific vendors and subjects them to algorithmic eligibility assessments, undermining autonomy and privacy.

Russian analysts describe the legislation as “cyber-serfdom,” comparing it to a form of digital feudalism where citizens are controlled and monitored by corporate interests. Moscow commentators draw parallels to Russia’s own 1990s “shock therapy,” depicting the bill as an elite effort to punish urban poor voters while rewarding rural constituencies.

Chinese media frames the bill as emblematic of U.S. social decay, warning that disinvestment in social safety exacerbates political polarization and risks civil unrest.

The American social safety net, historically fragmented and underfunded, now faces transformation into a system characterized by increased surveillance, privatization, and reduced federal commitment. This shift poses profound implications:

As the U.S. government implements austerity measures alongside significant tax cuts benefiting the wealthiest, the contradiction between professed American values and lived realities intensifies. Whether the nation can reconcile these contradictions remains an open question with significant domestic and geopolitical consequences.

If you found this analysis valuable, don’t miss future investigations. Subscribe to Lisa’s Oh. About That... Substack for grounded, personal truth, and human-centered perspectives, and Jerry B. Marchant’s for sharp geopolitical insight through a critical lens in Global Affairs.

Together, we bring clarity in a time of confusion.