States could help protect their most vulnerable by stopping unions from skimming money

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Wisconsin protects its most vulnerable, but in 11 other states, those needing in-home-care aren’t so lucky.

In those states, home caregivers — many of whom are looking after loved ones in their own homes —  may be trapped into paying unions dues thanks to union-backed laws classifying them as government workers.

Fortunately, Sen. Ron Johnson (R-Wisc.) has taken notice, demanding answers about this “dues skim” in an April 30 letter to the federal Centers for Medicare and Medicaid Services (CMS).

{mosads}These home caregivers are considered public employees simply because they receive support through the taxpayer-funded Medicaid program, and unions have organized them through dubious elections.


In 2011, Wisconsin put a stop to this scheme, ensuring its residents who need assistance receive the full funding promised to them by the state. Now, the state has the chance to share this reform, improving the quality of life for elderly, ill, disabled and financially disadvantaged Medicaid patients across the country.

Where this practice — known as dues skimming — occurs, unions siphon off dues directly from caregivers’ Medicaid payments before those funds even reach the patient they are intended to help.

This means that patients in need have fewer resources available to make their lives better and pay for much-needed care. It’s especially concerning considering the fact that some caregivers are unaware they even belong to a union and are unlikely to see many, if any, benefits in return for the money deducted from their checks.

Most people would agree that requiring a mother to pay union dues just so she can look after her disabled son is ludicrous, yet that’s exactly what dues-skimming does. And each year, it costs Medicaid patients and their caregivers an estimated $200 million, violating the program’s integrity and potentially jeopardizing its future.

Catherine Hunter, a Minnesota mom who cares for her disabled son Drew, expressed concern that using program funds for purposes never intended could hurt recipients beyond robbing them of financial resources.

“I’m very worried that having the union in place is going to compromise the tax dollars that are spent for this program and (the funds will) eventually be taken away from the people who need the tax dollars and the program the most,” she said.

Three years after Wisconsin stopped the practice, the U.S. Supreme Court ruled in the 2014 case Harris v. Quinn that home healthcare providers couldn’t be forced to pay union dues as a condition of employment.

Many government unions, like the Service Employees International Union, which organized 5,500 providers here in 2010 but never reached a contract before the 2011 reforms were instituted, have responded to this ruling in other states by enacting complicated and arbitrary rules to keep caregivers trapped in (and paying) the organization.

For example, in Oregon, SEIU 503 only permits caregivers to drop membership during a 15-day period that varies for each member. Caregivers in California are required to sit through a 30-minute-long union pitch just to work, while those in Washington state automatically have dues seized from their pay and must take the initiative to get out.

Today, “Wisconsin has the best health care quality in the country” the Wisconsin State Journal reported last year.

This praise comes less than eight years after massive Medicaid reforms, including stopping the dues skim before it got started, were instituted. In 2011, the Journal noted “Wisconsin’s Medicaid programs, which cover 1.2 million people, or one in five residents, face a $214 million shortfall this fiscal year and a $1.8 billion deficit over the next two years.”

While many states may not go as far as we did, it’s time at least for a permanent fix for the dues skim to protect our country’s most vulnerable people, and ensure home healthcare providers can focus on serving their patients, not fighting off unwanted union membership. Fortunately for the hundreds of thousands of in-home caregivers across the country, such a solution is within reach.

The U.S. Department of Health and Human Services can take administrative action to ensure that Medicaid dollars are not spent on union dues. Congress could also protect these workers and the Medicaid program by making it illegal for states to divert program dollars intended to help needy patients to unions.

Both solutions would preserve caregivers’ freedom to belong to a union — requiring simply that they pay the union dues on their own — while protecting Medicaid recipients’ access to care.

In his letter to CMS, Sen. Johnson asked the agency to review the “skimming” practice and “determine whether changes to law or regulation (at the federal level) are necessary to ensure the Medicaid funds are provided to the program’s intended beneficiaries,” Johnson wrote.

The hundreds of thousands of caregivers and others across the country should not be subjected to unwanted union membership that brings them little benefit when they’re working out of their own homes, often caring for relatives. It defies logic that unions could improve their working conditions.

Medicaid patients deserve the best care possible, but our most vulnerable will continue to suffer so long as unions take this money set aside for care and use it for their own selfish political purpose.

Brett Healy is president of the John K. MacIver Institute for Public Policy, a free market think tank based in Madison, Wisc.

Tags dues skimming Medicare Ron Johnson Unions

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