The Trump administration stands up for health-care workers and Medicaid recipients

Should Medicaid, a program created to provide health care to the poor and disabled, use its scarce dollars to fund union activities? Should state governments coerce mothers caring for their disabled children into joining unions? That is exactly what has been happening in a number Democrat-controlled states. To its credit, this month, the Department of Health and Human Services (HHS) proposed a regulatory change entitled, “Medicaid Program: Reassignment of Medicaid Provider Claims” — this will put a stop to this insidious, illegal practice

Independent in-home health-care providers help beneficiaries with personal care activities like bathing, dressing, grooming, and eating, among other activities, as part of Medicaid’s “home and community-based services” (HCBS). Nearly 60 percent of the approximately $170 billion Medicaid expends on long-term services go to HCBS. Most of these dollars are intended to allow Medicaid recipients to continue to live at home or in the community, rather than in expensive, restrictive nursing homes or other long-term care facilities.

Many, perhaps the majority, of independent in-home caregivers are relatives or friends of the individuals they assist.  Despite the lack of an obvious role for unions in these single worker, single employer, home-based relationships, government employee unions have aggressively attempted to unionize independent in-home health-care providers in a desperate attempt to bolster membership.

The standard modus operandi of unions and their Democrat allies in some blue states has been to designate independently contracting in-home caregivers as state employees solely for the purposes of collective bargaining.

Workers are denied all other benefits of employment such as access to state retirement plans, state health insurance plans, state employee workers’ compensation insurance, and even indemnity in the event of lawsuits. In these schemes, unions become the exclusive representatives of the providers, often by dubious means. States serve as organized labor’s dues collectors, automatically deducting the funds from workers’ Medicaid payments on the unions’ behalf.

In a lawsuit brought by Illinois-based independent in-home health providers, the United States Supreme Court in 2014 ruled that the caregivers are not obligated to pay union fees.

Nevertheless, some states have continued to deduct as much as $1000 a year from independent in-home health workers’ limited pay, often without their knowledge or consent. The Supreme Court decided last month held that true state-employed workers cannot be required to support unions as a condition of employment.

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