Michigan’s Proposed Medicaid Work Requirement Comes With a Racist Twist

A job fair in Detroit, Michigan.

Medicaid work requirements, the shiny new toy for Republican lawmakers across the country, may soon make their way to Michigan. But the proposal that passed the state senate in Lansing last week and is expected to sail through the house in coming days, puts a new, racist twist on the already-bad idea.

The bill, which requires proof of working 30 hours each week to maintain Medicaid coverage, contains an exemption for people residing in counties where unemployment exceeds 8.5 percent. That would leave the largely white residents of rural areas, some of which are represented by the bill’s sponsors, exempt from the onerous new rule. Meanwhile, people living in places such as Detroit and Flint would not get the same exemption despite the unemployment rate in those cities exceeding the same threshold.

Columnist Nancy Kaffer explains in the Detroit Free Press:

[Detriot’s] unemployment rate is higher than 8.5%, but the unemployment rate in surrounding Wayne County is just 5.5% — meaning Detroiters living in poverty, with a dysfunctional transit system that makes it harder to reach good-paying jobs, won’t qualify for that exemption. The same is true in Flint and the state’s other struggling cities.


Get that? Rural residents of up-north counties with high unemployment are protected; urban Michiganders who live in high-unemployment cities in more prosperous counties are left to twist.

Lawmakers haven’t offered an explicit explanation as to why this exemption is administered at the county level, but Kaffer suggests it’s an attempt to “pit urban and rural Michiganders with common interests against each other.”

The racial dynamics are also hard to ignore. Detroit Free Press reporter Niraj Warikoo notes that Detroit and Flint are both majority-black and adds that other racial minorities would be harmed too.

Even without the preferential treatment toward rural residents, the work requirement is a cruel and potentially useless policy.

Though proponents argue that work requirements will spur Medicaid recipients to become self-sufficient and find work, most Medicaid recipients in Michigan are either already working or unable to work. A study published last month found that only a quarter of Michigan residents receiving Medicaid are considered out of of work but capable of holding a job. Of that group, two-thirds claim a physical illness and a third say they have a mental illness. Under the new rules, they would be required to prove that they qualify for an exemption, a process that is made intentionally difficult and results in fewer people on the Medicaid roles. As long as those people don’t live in their districts though, the Republicans pushing Michigan’s requirements don’t seem to mind.

Michigan’s Medicaid Work Requirement Comes With Racist Twist