Exhorted by President Donald Trump, federal administrators and many Republican state officials are drafting rules requiring people to work in exchange for Medicaid, housing aid and food assistance. But what happens when the poor live where work is hard to find?
In Michigan, the state’s Senate has passed a proposal that would exempt Medicaid recipients from a work requirement partly on the basis of geography — if they live in a county where unemployment exceeds 8.5 percent.
Geography may seem a simple way to identify who faces barriers to work, but it’s also a crude one. The lines that policymakers draw risk embedding regional and racial biases about who counts as “left behind.”
Michigan’s approach, critics point out, would mean that poor, white counties are exempted, but not the predominantly black, economically troubled cities of Detroit and Flint. Those cities happen to be within counties with low suburban unemployment, which brings the unemployment of the counties below 8.5 percent.
There are similar demographic patterns in other states pursuing work requirements, including Kentucky, Virginia and Ohio, where the rural areas most likely to qualify for exemptions tend to be disproportionately white.
“This is trying to thread that needle between ‘are you poor because of structural reasons, where you live,’ or ‘are you poor because of your own choices?'” said Heather Hahn, a senior fellow in the Center on Labor, Human Services and Population at the Urban Institute.
The problem, Hahn and others say, is that geography captures just one kind of barrier to employment. “If you’re taking only the geography as the structure,” Hahn said, “it’s really overlooking the much more obvious racial structure.” African-Americans who face racial discrimination in the job market are more likely to have a hard time finding work.
And people who can’t afford cars and live where public transit is inadequate have a harder time. So do the poor with criminal records, or those without a high school diploma, or people with problems securing child care.
Policies that exempt high-unemployment places, but not people who face other obstacles to work, selectively acknowledge barriers for only some of the poor. In effect, they suggest that unemployment is a systemic problem in struggling rural communities — but that in poor urban neighborhoods, it’s a matter of individual decisions.
“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,” said David Super, a law professor at Georgetown University, who studies public welfare programs. But so are hardships that come from a lack of child care or transportation, he said. “It is troubling that one set of conditions are being taken seriously and another are being scoffed at.”
In Michigan, the proposed exemptions would also effectively protect the constituents of some state legislators who have advocated work requirements.
“What’s so galling here in Michigan is the social meaning of this exemption could not be more clear to people who live here,” said Nicholas Bagley, a professor at the University of Michigan Law School, who has argued in a series of blog posts and in a New York Times op-ed that the policy would run afoul of civil rights laws. “It is a way of extending solicitude to people who live in the hard-bitten white rural counties,” he said, but not to black residents in poor urban neighborhoods.
Other states with work requirements that have been approved could face similar challenges soon. The federal government’s approval letters have said that exceptions could be devised for economically troubled places.
But regions that have declined to invest in public transportation, or where policies have increased the costs of urban car ownership, have created the very definition of a structural barrier to employment.
Detroit is one of the most expensive places in the United States to insure a car, and its limited public transit doesn’t extend to many of the region’s jobs. In more than a quarter of households in the city, no one owns a car, Bagley points out. Conversely, in about 95 percent of households in the rural counties that would be exempted from work requirements, someone owns a car.
Michigan’s proposal illustrates that the details matter, and aren’t so easy to define. Is 8.5 percent unemployment the right cutoff? Are counties the best geographic unit? New Hampshire’s Medicaid waiver suggests the state will also consider places with limited educational opportunities and limited public transit. But how would you measure that?
The 1996 welfare reform law curtailed food stamps for childless adults without disabilities: They can receive the benefits for only three months out of any three years if they’re not working at least 20 hours a week. The law offered states waivers for places with “insufficient jobs,” but it did not define what that meant.
The Department of Agriculture now grants waivers for places the government designates “labor surplus areas” — places, many of them smaller than counties, where the unemployment rate is 20 percent higher than the national average. The 2018 list includes the cities of Detroit and Flint.
If states create geographic exemptions, those categories are a better way to do it, Super said. But that solution alone doesn’t address possible differences in the obstacles for rural and urban populations.
Urban hourly workers often can’t patch together enough consistent hours to earn a decent salary or meet work requirement rules — between 20 and 30 hours a week, depending on the state. Employers increasingly use complex formulas to determine work schedules, which vary by week or month. A recent study from the liberal Center on Budget and Policy Priorities found that around a quarter of low-wage earners working an average of 80 hours a month were likely to become ineligible for benefits during some months because of the variation in their hours.
States establishing Medicaid work requirements are also building in a series of individual exemptions. Parents of young children, people with serious illnesses, and those enrolled in school or job training, for example, will not need to meet the required hours to keep their benefits. But these categories still don’t cover many structural obstacles. New Hampshire, for one, has suggested one other exemption — for people who have faced “inclement weather.”
As states work through these details, the Trump administration has been pushing to expand work requirements for housing assistance, beyond current demonstration programs. And the president is advocating tougher work requirements for food stamps in the farm bill before Congress.
But for officials who feel it’s only fair to make people work for government aid, the question of whom it’s fair to exempt gets much murkier.