How a Medicaid program for people who are disabled is funding politics

This is a classic tale of good and evil, and the little guy getting pushed around by the big guy.

In the 1970s, our country moved away from institutionalizing disabled people, in favor of keeping them at home, with their family, whenever possible. Today some disabled people get certain benefits from Medicaid. They can use their Medicaid grant to hire personal care attendants (PCAs) to help them with daily living. Not only does this offer a superior care model, it is less expensive for taxpayers.

Under a program known as “PCA Choice” disabled adults are able to hire a PCA, often a family member, who is paid a very modest hourly rate to help with daily needs. The “Choice” program (along with two smaller programs called Flexible Use and Shared Option) was designed with families in mind — and it was, until recently, the preferred option because it offers the most control over the benefit. As a PCA, you were employed by the Medicaid recipient (not an agency or the state).

But that all changed in 2013 when Minnesota Gov. Mark Dayton made good on a campaign promise to the unions that help him, and other legislators, get elected. The DFL-majority in the state Legislature passed a law that subjected thousands of Choice PCAs to unionization by declaring them “public employees.” The underlying theory is quite twisted: Use welfare payments paid to PCAs caring for the disabled as a new source of union dues.

The Service Employees International Union (SEIU) went on to win an “election” with just 13 percent of PCAs voting for the union. PCAs are now “organized” in Minnesota and 12 other states under the same scheme.

We estimate, based on federal filings, that the SEIU in Minnesota is skimming about $4.7 million from PCAs around the state. The SEIU takes 3 percent of PCAs’ gross wages up to $948 a year from people they targeted as “low-income workers.” And now SEIU has negotiated essentially a taxpayer-funded rebate of $500 for dues-paying members who attend a first aid class offered by — you guessed it — the SEIU.

How could this happen? Under Minnesota law, all you need is half of the targeted “public employees” to vote “Yes.” SEIU canvassed Minnesota for years, hand-picking PCAs who would vote for the SEIU. The state also used a mail-in ballot that could easily be mistaken for junk mail. Most of the PCAs targeted did not even know there was an election. Some never got a ballot.

Choice PCAs are now “public employees” who can “collectively bargain” but they do not have benefits like health care or pensions. And that is why the U.S. Supreme Court ruled in 2014 that these PCAs are not really public employees, so they cannot be forced to pay union dues like all other public employees.

If PCAs cannot be forced to pay dues, what is the problem? Well, it turns out that union dues are the least of the problems facing Choice PCAs.

SEIU’s attempt to “exclusively represent” these PCAs and their families is threatening the program itself, and driving a wedge between PCAs who are caring for a family member, and PCAs who do this for a living.

We estimate that when this all started at least 80 percent of Choice PCAs were taking care of a family member, as the program intended. But the union has changed all that; we have seen PCAs fleeing the Choice program they prefer and enrolling as employees of an agency instead. The SEIU is also pushing for benefits like those received by actual public employees. That will ultimately upend the program, triggering tax consequences for PCAs.

The small percentage of PCAs who do this for a living do not have the same core interests as someone caring for a family member. They may care deeply about the people they attend, and provide excellent care, but they want more out of the Medicaid program than it was designed to give. For example, PCAs who care for a family member scoff at the idea of paid time off or holiday pay.

Choice PCAs pushed back, launching a group called MNPCA, a coalition to decertify the SEIU. In 2014, 3,543 PCAs voted for the SEIU. MNPCA submitted 4,500 signatures from PCAs calling for a new election. They are confident they can win: they just needed the Dayton administration to give them a fair chance to vote.

Unfortunately, the state Bureau of Mediation Services just denied MNPCA’s request for a new election. So MNPCA has to go back to court.

The Dayton administration has done everything in its power to stop MNPCA. It refused repeatedly to give MNPCA an accurate list of PCAs, even admitting in court that it had not kept the list as required by law, and had to be ordered by a court to do so repeatedly.

MNPCA also asked for an investigation of the SEIU’s original election. The list used by the union had a huge percentage of non-existent names and addresses, or names that were not PCAs. Also, PCAs who never signed a union card are paying big union dues. Others have testified that SEIU organizers tried to pressure them into signing cards, or told them the cards were “just for information.” This is fraud.

And fraud is what happens when we let politicians tap into Medicaid and other welfare programs to fund their campaigns. Let’s not let this indefensible scheme take permanent hold in Minnesota.

If you were or are a Choice PCA, please say a prayer that MNPCA can convince the judge to give you a new election. If you have not sent in your own election card, go to and mail it in today.

Kim Crockett is vice president and general counsel at Center of the American Experiment, where she directs the Employee Freedom Project. She worked as a nursing aide in high school and college.

This originally appeared as an op-ed in the Pioneer Press.