States Are Effectively Exempting Rural Whites From Medicaid Work Requirements

Screengrab/ABC News/YouTube

In Michigan, rural, predominantly white counties are more likely to get an exemption while urban areas would not.

One of the outcomes of President Donald Trump’s decision to allow state-mandated work requirements for Medicaid beneficiaries is that poor black people are likely to be disadvantaged while poor white people are more likely to be freed from the rules.

Vox explains how this plays out using Michigan as an example:

In Michigan, as the Detroit Free Press’s Nancy Kaffer noted, state lawmakers are pushing a plan that would require Medicaid recipients (with exceptions for the disabled, elderly, and a few other selected populations) to work or search for work at least 29 hours each week. If they fail to meet the work requirement, they could lose Medicaid coverage for a full year.

However, the plan makes an exception for counties where the unemployment rate is above 8.5 percent – a condition far more likely to be met by rural counties with higher white populations than counties with urban areas that are home to more black people.

Take a look at the three Michigan counties highlighted by Vox:

Cheboygan County, which, as the Free Press noted, is represented by one of the authors of the Medicaid requirement plan:

  • 93 percent white, per the Census Bureau
  • 0.6 percent black
  • 18.7 percent unemployment rate in March 2018, according to the state government
  • It would therefore be exempt from the work requirement

Genesee County, home of Flint, already the site of racially fraught state policymaking:

  • 75 percent white
  • 21 percent black
  • 5.8 percent unemployment rate
  • It would there[fore] not be exempt from the work requirement

Wayne County, the big one, which includes Detroit and surrounding areas:

  • 55 percent white
  • 39 percent black
  • 5 percent unemployment rate
  • It would not be exempt from the work requirement

Wayne County’s 5 percent unemployment rate doesn’t present a full picture of the jobs situation, but it would still be subject to the work requirements.

The Brookings Institution reported in February of last year (so the exact data is out of date, though the trendlines surely hold) that the white unemployment rate in the city of Detroit was 4.9 percent — and the black unemployment rate was 14.5 percent.

In the end, low-income individuals in counties that are predominantly white will likely avoid the newly-added work requirement, while low-income black people in urban areas will face an impediment to acquiring medical care.

Intentional or not, the potential for racial disparity is real.

Vox notes that while the measure passed the Michigan Senate, Republican Gov. Rick Snyder has voiced opposition to the plan.

The legislation faces a potential roadblock in GOP Gov. Rick Snyder, whose office said the version now headed to the House is “neither a reasonable nor responsible change to the state’s social safety net.”