Ohio’s new Medicaid proposal could screw over its poorest urban communities

Medicaid "redlining" in Ohio means Appalachia gets a break and Cleveland doesn’t.

Poor people in Ohio’s majority-black inner cities could soon have to work in exchange for Medicaid, a compromise people in rural Ohio won’t have to make.

The proposal, dreamed up by Ohio Senate Republicans and put into effect by the state’s Department of Medicaid, would require low-income recipients of public health care to work or volunteer for 20 hours per week. The plan still requires federal approval.

“They feel like a lot of us who trying to get assistant from them, from the government, they think that we all lazy, and we don’t want to work,” said Iesha Parker, a 32-year-old mother of two and Medicaid recipient from Cleveland. She makes just above minimum wage working part-time as a home healthcare aide and just meets the required hours for the state’s new plan.

But not everyone will have to abide by the work requirements, which have spurred questions about the fairness of the policy. Ohio has exempted counties where unemployment exceeds 120 percent of the national average. In Ohio, counties with the highest unemployment are rural and mostly white. But pockets of extreme poverty also exist in majority-black, urban areas. Cleveland, for instance, sits in Cuyahoga County, where rich suburbs surrounding the city drive unemployment way down.

That means people in inner-city Cleveland have to work to get health care even with unemployment as high as Appalachia’s poorest counties — or be forced off of Medicaid entirely. Sociologists say the state is, in their words, “redlining” poor, urban, majority-black communities by putting onerous requirements on their health care while leaving rural, white counties exempt.

This segment originally aired August 14, 2018 on VICE News Tonight on HBO.