They’re so clever, aren’t they?

As the Trump administration moves aggressively to allow more states to impose mandatory work requirements on their Medicaid programs, several states have come under fire for crafting policies that would in practice shield many rural, white residents from the impact of the new rules.

In the GOP-controlled states of Kentucky, Michigan, and Ohio, waiver proposals would subject hundreds of thousands of Medicaid enrollees to work requirements, threatening to cut off their health insurance if they can’t meet an hours-per-week threshold.

Those waivers include exemptions for the counties with the highest unemployment, which tend to be majority-white, GOP-leaning, and rural. But many low-income people of color who live in high-unemployment urban centers would not qualify, because the wealthier suburbs surrounding those cities pull the overall county unemployment rate below the threshold.

“This is sort of a version of racial redlining where they’re identifying communities where the work requirements will be in full effect and others where they will be left out,” George Washington University health law professor Sara Rosenbaum told TPM. “When that starts to result in racially identifiable areas, that’s where the concern increases.”