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Flint Water Crisis: Policy Measures to Address the Health Consequences of Lead Poisoning

posted on Wed, May 4 2016 1:25 pm by Marie DeFer

In a previous post, the Network examined the factors that contributed to the water crisis in Flint, Michigan, where elevated levels of lead were found in some children’s blood after the city switched its drinking water source to the Flint River. The water, which was improperly treated, corroded old pipes causing lead to leach into the tap water of homes and businesses.

Lead poisoning affects people of all ages. Children and pregnant women who suffer from prolonged lead exposure are especially at risk for serious lifelong health and socioeconomic consequences. Children, for example, absorb lead at four to five times the level of adults. In addition to its irreversible health consequences, lead poisoning can also cause death.

The potential health consequences of lead poisoning that each population may experience:


Pregnant women:


Even more alarming, researchers recently determined that lead poisoning permanently alters humans’ DNA. This means that residents of Flint who suffer from lead poisoning may not only experience these health consequences, but may also pass on deleterious health conditions to their children and grandchildren.

Lead poisoning is often irreversible and policymakers should increase measures to mitigate the effects of lead poisoning. The following suggestions require all levels of government to work together to mitigate harm to Flint residents by improving the public health, infrastructure, and education system in Flint.

Health Care & Food Policy Measures

  • Lead Testing. While children covered by Medicaid (insurance for low-income and disabled individuals) are guaranteed access to lead poisoning prevention programs, policymakers must ensure that robust lead screenings are conducted, all eligible children are screened, and reporting requirements are met.
  • Expanded Medicaid. The Centers for Medicare and Medicaid Services (CMS) approved the State of Michigan’s 1115 demonstration waiver to extend Medicaid to certain pregnant women and children through the age of 21 who were served by the Flint water system. While this is a step in the right direction, additional steps should be taken. First, the new Medicaid program excludes coverage to lawfully residing immigrant children and pregnant women. Because CMS permits States to expand Medicaid services to lawfully residing residents, Michigan should extend Medicaid coverage to all lawfully residing children and pregnant women who were served by the Flint water, regardless of immigration status.  Second, while the approved waiver allows Flint children and pregnant women above 400 percent of the Federal Poverty Level to purchase Medicaid coverage, the approved waiver fails to specify the details of the private payment option. This is important because Medicaid covers comprehensive services through the Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT) benefit, which is unlikely to be covered by private health insurance.
  • Healthy Food. Research shows that diets rich in Calcium, Vitamin C and Iron help counteract the effects of lead poisoning. The State should provide supplemental assistance to ensure access to such food through its Supplemental Nutrition Assistance Program (SNAP) and Women, Infants & Children (WIC) program.
  • Ensure Free Water. Flint’s water is still not safe to drink and optimistic estimates predict that it will take at least one year for Flint to replace all of its lead pipes. Many residents in Flint are disabled, low-income, and do not have access to affordable and reliable transportation, which makes it difficult or impossible for residents to collect rationed water donations throughout the city. Until Flint residents have access to safe water, the State should ensure all residents have water delivered to their homes.

Infrastructure: Replace all Lead Pipes. All levels of government must work together to ensure damaged water pipes are replaced to avoid the potential for lead contamination in drinking water. A plan is currently underway, but this effort will require ongoing resources and accountability to ensure it is completed in a timely manner.

Expansion of Early Childhood & Robust K-12 Education. The State should consider increasing early educational resources to mitigate the social, behavioral and cognitive developmental delay effects of lead poisoning. Additionally, educators should develop policies to identify lead-poisoned children and develop specialized educational plans for each affected child.

Access to Resources & Information. A big barrier to needed services for low-income or at-risk populations is lack of information. For example, immigrants in Flint were unaware of the lead crisis because of language-access barriers; additionally, some were denied access to free bottled water and filters because they were unable to show a valid form of identification. The State should ensure all Flint residents have access to free water and filters, regardless of immigration status. The State should also devote resources to ensure that people eligible for Medicaid, SNAP, and other assistance enroll in such services.

While agencies at all levels of government have devoted tremendous resources to investigate how the Flint Water Crisis began, it is critically important that policymakers plan for Flint’s future, with special attention to ongoing budgetary expenditures. Policymakers must take concrete steps now to mitigate the devastating effects of lead poisoning and to ensure comprehensive and fair services for all Flint residents.

This guest post was developed by Marie DeFer, Staff Attorney at the Center for Civil Justice, a non-profit law firm based in Flint, Michigan.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this post does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. 

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.

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