Medicaid waiver proposals that subject recipients to bureaucratic hurdles such as work requirements are having a disparate impact on communities of color.
We have long known that imposing such requirements will force people off the rolls, and that those who are forced to work, but are not able to do so, will see their health decline.
Now we are also seeing that, in an effort to mitigate these harms in rural, predominantly white counties where few jobs are offered, the government will make an exception to the work requirement rule.
This is particularly problematic because the unemployment rate in urban centers is often just as bad or worse than it is in rural areas. However, it is masked by the use of countywide data that includes much more affluent, white neighborhoods.
Once again, disadvantaged communities of color are in the crosshairs of “welfare reform.” But these changes are not reform. They are benefit cuts intended to save tax dollars by kicking people of color off the rolls who are deemed “undeserving” by criteria that are neither fair nor objective.
We’ve seen this before. We don’t need to make this mistake again.
In January, the SPLC, the National Health Law Program and the Kentucky Equal Justice Center sued the Trump administration after it approved Kentucky’s Medicaid waiver application, in violation of the objectives of the Medicaid Act, which is supposed to guarantee health care to people who are in need. The litigation is pending, and a ruling is expected before the key provisions go into effect in July.