Michigan lawmakers have advanced a proposal to implement Medicaid work requirements that would exempt beneficiaries who live in counties with high unemployment rates—but experts say the proposed exemption might not apply to some individuals who have difficulty finding jobs.
According to the New York Times' "The Upshot," Michigan's Senate has passed legislation that seeks to implement work requirements for certain Medicaid beneficiaries. The proposal would exempt affected beneficiaries from the requirements if they live in a county that has an unemployment rate higher than 8.5%. Currently, there are 22 counties in Michigan with unemployment rates higher than 8.5%, according to "The Upshot."
Some say proposed exemption won't help those who face most difficulty finding jobs
However, some experts have said the proposal would not help individuals who face the most difficulty getting jobs, "The Upshot" reports.
According to "The Upshot," critics have said that the exemption would apply mostly to low-income rural counties that have more white residents than black residents. They noted that predominantly black areas with high unemployment rates, such as Detroit and Flint, would not be included in the exemption because they are located in counties that have low suburban unemployment rates, bringing those counties' overall unemployment rates below the 8.5% threshold.
Heather Hahn—a senior fellow in the Center on Labor, Human Services, and Population at the Urban Institute—said Michigan's proposal "tr[ies] to thread that needle between 'are you poor because of structural reasons, where you live,' or 'are you poor because of your own choices?'" However, Hahn said basing the exemption on geography captures only one barrier to employment. "If you're taking only the geography as the structure, it's really overlooking the much more obvious racial structure," she said.
For instance, "The Upshot" reports that blacks can face racial discrimination in the job market, making it difficult for them to find jobs. In addition, individuals who cannot afford vehicles and who do not live near adequate public transportation could face barriers to finding work, as well as individuals who have criminal records, who do not have high school diplomas, or who have a hard time finding child care.
According to "The Upshot," Detroit highlights the exemption's potential disparity. Research shows that Detroit is one of the most costly places in the country to insure a vehicle, and its public transit system does not serve many areas where the region's jobs are located. Nicholas Bagley, a professor at the University of Michigan Law School, said in more than 25% of households in Detroit, no individuals own a car, compared with a rate of about 5% in rural counties that would be exempted from the proposed Medicaid work requirements.
David Super, a law professor at Georgetown University, said, "The hardships of areas that have seen industry leave are very real; the hardships of rural areas that have had jobs automated away are real," and so are hardships related to a lack of transportation or child care. "It is troubling that one set of conditions are being taken seriously and another are being scoffed at," he said (Badger/Sanger-Katz, "The Upshot," New York Times, 5/15; Baker, "Vitals," Axios, 5/16).
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