São Paulo, Brazil — Eligibility for Medicaid, Health Care for the Poor or Medicaid Services in the United States can often be determined by the color of one’s skin.
Or skin color, to be more specific. There are two census categories for skin color: Black and mixed. Whites and other non-mixed skin types count as Black.
Though immigration has transformed racial diversity in the U.S., the use of census categories for such racial difference in Brazil can be traced back to 1986, when the country adopted a change to its skin color classification that marked all non-Hispanic blacks as Non-Black or Mixed and interpreted it to indicate no discrimination.
Medicaid was first introduced in Brazil in 1975 and became available for all non-Hispanic, non-pigmented populations in 1977. The first year 1.2 million Brazilians enrolled in the state or federal public health insurance program, and 10 years later an estimated 2.8 million non-minority Brazilians had been enrolled. More than half of Brazil’s population was covered in 2016.
Now Brazil is at the bottom of the U.S. heap in terms of skin color among industrialized nations. By per capita comparison, only the United States had higher rates of extreme poverty among non-white racial groups, according to the latest U.N. Human Development Index (HDI).
Brazil’s national poverty index between 1999 and 2017 was 143.3. The U.S. poverty index for those with deep poverty in the same time period was 141.6.
For Brazilians from non-pigmented ethnic groups, Poverty is defined as more than ₡30,000 ($6.45) per month, and Extreme Poverty means less than ₡0,000 ($0.25) per month. More than half of the population had no color coverage in 2016.
Medicaid, which is administered by each of the country’s 25 states, had 1.7 million enrollees from non-multiracial ethnic groups in 2016, and helped 14 million Brazilians receive health insurance.
The U.S. Department of Health and Human Services did not respond to requests for comment.