Congress created Medicaid to exclusively fund care to the elderly and disabled, not fund labor unions. But powerful labor unions like the Service Employee International Union (SEIU) and American Federation of State, County, Municipal Employee union have turned this publicly funded assistance and other programs into effectively their own personal slush fund.
In at least 11 states, unions have siphoned off an estimated $200 million from Medicaid and other government assistance programs that was supposed to go to paying for patient care, according to a Mackinac Center for Public Policy report.
But what does a family caregiver taking care of a parent or child need a union for? Normal benefits a union may negotiate, like overtime or days off, for members do not comport with caregivers taking care of family. There is no good reason to impose a union between a family caregiver and a Medicaid patient.
But that’s what has happened. Unions went ahead and “organized” these workers, despite the fact that many, maybe even most, home or child care providers did not even realize a union election was underway.
For example, in 2005, former Illinois Gov. Rod Blagojevich issued an Executive Order calling for a mail ballot union election for day care providers who participated in the state’s child care assistance program, but since the election was not highly publicized, only about 16,700 day care providers out of around 50,000 eligible voters returned ballots. While the SEIU received strong support among voters, around 80 percent, in reality that meant about 14,000 child care workers decided the fate of the other 49,000.
Ultimately, the U.S. Supreme Court ruled in Harris v. Quinn that it was unconstitutional for states to require home care aides and family child care providers to pay dues as a condition of employment. But this did not put an end to what the Supreme Court called a “scheme.” Unions have found workarounds to keep caregivers paying dues.
In the state of Washington, caregivers still have union dues automatically deducted from their pay, whether or not they authorized the payments. For those who never authorized dues payments, these caregivers must learn that they have the right to opt out, which is difficult because many providers do not even realize they are part of the union. Assuming a caregiver knows about their de facto union representation and wants to go through the process of opting out, he or she must send a letter to the union asking to opt-out of paying.
Even then, it can be difficult to get out of paying dues if a caregiver ever previously signed up to be a member of the union. In many cases, caregivers only have a short, arbitrary window to opt-out that coincides with the anniversary of when the employee first signed a union membership form.
Congress should take some oversight responsibility, ending this system of states automatically deducting union dues from Medicaid payments. Even more egregious, a good portion of the dues payments are going toward political activity and lobbying. Homecare providers deserve the personal freedom to decide whether to pay union dues or not. Congress needs to step in to ensure Medicaid and other federal assistance are financing care for the elderly and disabled, not union priorities.
Trey Kovacs is a policy analyst for the Competitive Enterprise Institute, a free market public policy organization based in Washington, D.C.