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At the height of the opiate epidemic, Tennessee lawmakers made it a crime for a pregnant woman to transmit narcotics to a fetus. They promised that charging new mothers with this crime would help them receive the treatment and support they often desperately need. In Prosecuting Poverty, Criminalizing Care, Wendy Bach describes the law's actual effect through meticulous examination of the cases of 120 women who were prosecuted for this crime. Drawing on quantitative and qualitative data, Bach demonstrates that both prosecuting 'fetal assault', and institutionalizing the all-too-common idea that criminalization is a road to care, lead at best to clinically dangerous and corrupt treatment, and at worst, and far more often, to an insidious smokescreen obscuring harsh punishment. Urgent, instructive, and humane, this retelling demands we stop criminalizing care and instead move towards robust and respectful systems that meet the real needs of families in poor communities.
This chapter argues that federalism-based controversies in the social welfare field over legal structures, legal rules, and the location of governance are best understood as arguments about both deservingness and control played out through controversies about administrative structure. In short, programs are called “welfare,” or are urged by some to be more like “welfare,” when what is really meant is that we wish to use the administrative mechanisms of federalism to control, stigmatize, punish, and deter recipients. In contrast, when we perceive recipients as entitled, these mechanisms fall away to be replaced by purely federally controlled, far less visible, and far more inviting administrative structures. To make this process visible, the chapter describes the administrative tools of benefit programs across the economic spectrum, as well as the corresponding cultural assumptions tied to programs across this spectrum, and then contextualizes a debate like the one over Medicaid work rules in this context.