Medicaid work requirements are a bad deal all around – putting health care access at risk for millions of young adults. And while the impact of Medicaid work requirements would be devastating for low-income young adults across the country, they would disproportionately hurt young people of color.
People of color – including young adults – already experience poorer health care access and lower quality care than white Americans. Just look at Kentucky where our analysis shows that African Americans make up 10 percent of the young adult population, but account for 14 percent of the young adults who could lose Medicaid coverage under under the state’s new work requirements. Due to systemic and structural barriers, black Kentuckians are already uninsured at a higher rate than white Kentuckians, and adding discriminatory and burdensome work requirements would only deepen health care inequality for black communities.
While many young adults face tough economic challenges due to underemployment, rising college costs and lower salaries than older generations, young people of color have an even tougher hill to climb. For example, the median net wealth for young African Americans has declined by nearly half since 1989. And although the economy improved as a whole between 2013 and 2016, young African Americans continued on a financial decline. With so many barriers in society that keep young people from getting ahead, the last thing they need is to lose access to health care.
The complex monthly process of proving employment status and hours would also aggravate existing racial disparities. Some states only allow Medicaid recipients to complete their verification forms online. In Arkansas, for instance, Medicaid enrollees have to report their work requirements through a state-run, online portal without an option for phone or mail-in reporting. And the portal is only available during certain hours of the day, presenting a huge challenge for young adults that do not have reliable internet at home. That’s disproportionately true for people of color – according to research by Pew, only 47% of Hispanic and 57% of Black adults were home broadband users in 2018, compared to 72% of white adults.
States implementing work requirements like this are now unfairly linking the disparity in rates of internet access to dire inequality in who has access to health care and who doesn’t. Thousands of young people of color could lose their Medicaid benefits, not because they aren’t working, but simply because they don’t have the means to complete the online verification process. And when considering alternatives like using a computer at a public library, Blacks and Latinxs also have lower rates of car ownership than Whites. So, finding reliable transportation would be just another obstacle on the path to securing their basic health care.
As The Washington Post analyzed and reported in May, even policies that waive work requirements are crafted in a way that lets people in areas with high unemployment – who are more likely to be white people living in rural communities – off the hook, but doesn’t offer relief for unemployed people of color in metropolitan areas. In Michigan, for example, “whites would account for 85 percent of those eligible for the unemployment exemption, despite making up only 57 percent of the potentially affected population. African Americans, in contrast, would constitute a mere 1.2 percent of people eligible for an exemption, despite being 23 percent of the affected Medicaid population.”
The fact of the matter is that major health care inequalities already exist for people of color and Medicaid work requirements would only deepen those imbalances. To put simply, Medicaid work requirements are racially discriminatory and will jeopardize the livelihood and well-being of thousands of young people of color if they aren’t stopped.