Standing Up for the Health of Black Americans

Al Green (D-TX) (2012) | Talk Media News Archived Galleries | CC BY-NC-SA 2.0

On March 4, Rep. Al Green (D-TX) was censured by his Congressional peers for interrupting President Trump’s joint address to Congress. What was lost in the media coverage of Green’s censure is the content of his comments—he was condemning Trump for projected cuts to Medicaid, which are certain to exacerbate existing racial health inequity. 

Two weeks prior to the censure, on February 18, Rep. Jodey C. Arrington (R-TX) introduced a resolution that ordered the House Committee on Energy and Commerce, which has jurisdiction over Medicaid, to cut at least $880 billion from its budget between the fiscal years 2025 and 2034. Since Medicaid accounts for 93 percent of the $8.8 trillion in projected spending between 2025 and 2034, the proposed cuts would, at a minimum result in a $260 billion cut to Medicaid—and a betrayal of Trump’s promise to the electorate that the House budget plan will not cut Medicaid benefits. For this reason, Green interrupted Trump’s address to remind Congress that “he has no mandate to cut Medicaid.”

Green did not dispute the censure, justifying his conduct as “righteous incivility” because health care is at stake for lower-income people in his district and across the country. Nonetheless, many headlines reduced his actions to an outburst that impelled a bi-partisan censure. For instance, USA Today published an article titled “Rep. Al Green’s heckling leads to punishment: What it means to censure a politician.” The article explained the censure’s repercussions and listed the ten Democrats who voted in favor of Rep. Dan Newhouse’s (R-WA) resolution. 

One media outlet that focused on the content of Green’s interjection was PBS, which posts current events questions for teachers to ask students between grades 6 through 12 in its News Hour Classroom. The lesson on March 7 focused on Green’s censure and included the following question: “Why do you think Green felt it was necessary to interrupt Trump’s address to get his point across?” It is unclear how many teachers downloaded this lesson or how their students responded, but the question warrants attention from the voting public—not just our children. The proposed Medicaid cuts would have a racially disparate impact throughout Green’s district, and across the United States. In Texas, Black and White people comprise 23.1 percent and 9.3 percent of Medicaid recipients, respectively. Across the country, Black Americans are twice as likely as White Americans to be Medicaid recipients. 

Even before the proposed cuts, Medicaid has struggled to provide equitable care. Black Medicaid recipients report lower quality health care than White recipients, disparities which may be due to physicians’ racial bias or lack of structural competency, which allows them to neglect to investigate confounding factors that impact health outcomes, such as food insecurity, substandard housing, or exposure to air pollution. Cutting Medicaid can only exacerbate these issues, causing irreparable harm to Black Americans’ health. 

Compounding the dangers of the proposed Medicaid cuts is the fact that the House Committee on Energy and Commerce also has jurisdiction over the Clean Air Act. The Environmental Protection Agency’s (EPA) environmental justice initiatives have ended in light of the Trump administration’s environmental rollbacks, which represents the biggest deregulatory action in US history, one that will intensify already severe environmental health disparities. Black Americans are disproportionately exposed to air pollution and have the highest risk of dying from causes related to air pollution, and even short-term exposure to air pollution has been found to increase the probability of hospitalization for respiratory and cardiovascular issues among Medicaid recipients. The threat of defunding Medicaid, coupled with the EPA’s deregulation, brings into focus the interplay between environmental racism and health inequity, illuminating the new administration’s negligence toward Black Americans.

Lower-income people of all races and ethnicities will be affected if the House Committee on Energy and Commerce proceeds with Medicaid cuts. In a press conference held at a community health clinic in his district, part of the Democrats’ Medicaid Day of Action on March 18, Green reiterated why he disrupted President Trump’s joint address to Congress: “I did it because there are people who will suffer.” And the data shows us that no population will be more impacted than Black Americans, already disproportionately affected by the administration’s eradication of diversity- and equity-based initiatives. Congressman Green’s censure should not be the news story here. The grave threat posed to the health of many Black and lower-income Americans should prompt the rest of us to join Green in acts of righteous incivility.