Medicaid Work Requirements and the Politics of Whiteness

Kentucky has received permission from the Trump administration to roll out work requirements for Medicaid later this year. Eight counties have been exempted from the new requirements for a while:

That’s coal country down there, and unemployment is pretty high. As you might guess, the population is also pretty white:

It’s hard to tell if there was any racial motivation here. The exempt counties are historically among the poorest in the state, and coal country often gets special consideration in Kentucky. But then Ohio and Michigan took a look and decided to follow suit by implementing Medicaid work requirements but exempting counties with high unemployment. In Michigan, the cutoff was 8.5 percent unemployment, which happens to describe only about a dozen rural, white counties. If they had done it by city instead, it would look like this:

Detroit and Flint—both with large black populations—have high unemployment rates and should qualify for exemptions. But they don’t because they’re part of larger counties with low unemployment rates. That’s a tough break, isn’t it?

But here’s the odd thing. The official excuse for this is that unemployment rates are consistently available at the county level but not at the city level. That’s what the feds give them, so that’s what they have to work with. Except it’s not true. In Kentucky, they may have exempted a bunch of folks from coal country who happen to be white, but that’s sort of a misdemeanor as these things go. For the rest of the state, they exempted people from the work requirement if they already qualify for exemption from the SNAP work requirement. That’s pretty easy, after all. States already have the SNAP exemptions figured out, so there’s zero work involved in using that.

But here’s the thing: SNAP exemptions are based on both cities and counties as the regions of interest. In Michigan, for example, both Detroit and Flint are designated as “Labor Surplus Areas” and therefore qualify for exemptions. So Michigan latched onto Kentucky’s idea of exemption by county but decided not to follow their lead in using SNAP criteria for most of the state.

Why? It’s a mystery. But the bottom line is this: Michigan passed up on the easiest exemption criteria, instead making up a brand new one that just happens to exclude the biggest black populations in the state. Ohio is going down the same road, and a bunch of other red states are queued up behind them. Is this just a big coincidence? It hardly seems likely, does it?

POSTSCRIPT: It’s worth noting the political genius of this, which goes well beyond favoring whites over blacks. It’s also guaranteed to provoke a lot of blowback—like this post, for example. Republicans can then sigh and throw up their hands: You liberals have to make everything about race, don’t you? We just wanted to encourage able-bodied welfare recipients to find jobs. They don’t mention that they did this deliberately and were probably hoping for exactly this blowback since it does nothing but help them with their base, which thinks the exact same thing.

The alternative is that they’re all so innocent that they didn’t even notice the racial impact of their handiwork. I leave it to you to decide how likely that is.

WE'LL BE BLUNT.

We have a considerable $390,000 gap in our online fundraising budget that we have to close by June 30. There is no wiggle room, we've already cut everything we can, and we urgently need more readers to pitch in—especially from this specific blurb you're reading right now.

We'll also be quite transparent and level-headed with you about this.

In "News Never Pays," our fearless CEO, Monika Bauerlein, connects the dots on several concerning media trends that, taken together, expose the fallacy behind the tragic state of journalism right now: That the marketplace will take care of providing the free and independent press citizens in a democracy need, and the Next New Thing to invest millions in will fix the problem. Bottom line: Journalism that serves the people needs the support of the people. That's the Next New Thing.

And it's what MoJo and our community of readers have been doing for 47 years now.

But staying afloat is harder than ever.

In "This Is Not a Crisis. It's The New Normal," we explain, as matter-of-factly as we can, what exactly our finances look like, why this moment is particularly urgent, and how we can best communicate that without screaming OMG PLEASE HELP over and over. We also touch on our history and how our nonprofit model makes Mother Jones different than most of the news out there: Letting us go deep, focus on underreported beats, and bring unique perspectives to the day's news.

You're here for reporting like that, not fundraising, but one cannot exist without the other, and it's vitally important that we hit our intimidating $390,000 number in online donations by June 30.

And we hope you might consider pitching in before moving on to whatever it is you're about to do next. It's going to be a nail-biter, and we really need to see donations from this specific ask coming in strong if we're going to get there.

payment methods

WE'LL BE BLUNT.

We have a considerable $390,000 gap in our online fundraising budget that we have to close by June 30. There is no wiggle room, we've already cut everything we can, and we urgently need more readers to pitch in—especially from this specific blurb you're reading right now.

We'll also be quite transparent and level-headed with you about this.

In "News Never Pays," our fearless CEO, Monika Bauerlein, connects the dots on several concerning media trends that, taken together, expose the fallacy behind the tragic state of journalism right now: That the marketplace will take care of providing the free and independent press citizens in a democracy need, and the Next New Thing to invest millions in will fix the problem. Bottom line: Journalism that serves the people needs the support of the people. That's the Next New Thing.

And it's what MoJo and our community of readers have been doing for 47 years now.

But staying afloat is harder than ever.

In "This Is Not a Crisis. It's The New Normal," we explain, as matter-of-factly as we can, what exactly our finances look like, why this moment is particularly urgent, and how we can best communicate that without screaming OMG PLEASE HELP over and over. We also touch on our history and how our nonprofit model makes Mother Jones different than most of the news out there: Letting us go deep, focus on underreported beats, and bring unique perspectives to the day's news.

You're here for reporting like that, not fundraising, but one cannot exist without the other, and it's vitally important that we hit our intimidating $390,000 number in online donations by June 30.

And we hope you might consider pitching in before moving on to whatever it is you're about to do next. It's going to be a nail-biter, and we really need to see donations from this specific ask coming in strong if we're going to get there.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate