A win for home health care workers

The Trump administration ends medicaid dues-skim, tells unions to collect their own dues.

Minnesota Personal Care Attendants (PCAs) won a significant victory when the Trump administration overturned an Obama-era policy that allowed government unions to skim Medicaid payments.

Saying the rule violates plain language in the Social Security Act, Trump’s regulators ignored a flood of union comments opposing the change. Center of the American Experiment led efforts to support the change through public comments from Minnesota PCAs and state lawmakers. “Minnesota is diverting Medicaid monies from their intended purpose—paying for care for the disabled—to subsidize political activities conducted by government unions, as well as ‘training’ used for union recruitment and indoctrination,” according to the Center’s comment.

Kris Greene and Catherine Hunter, mothers of disabled children, founded MNPCA.org in hopes of decertifying the Service Employees International Union (SEIU). With the help of the Center and labor lawyer Doug Seaton, MNPCA. org collected over 11,000 cards from PCAs who want to vote out the SEIU. The decertification was thwarted at every turn by the Dayton administration, which worked with the SEIU and the trade union AFSCME to bring the dues-skim to Minnesota. Both unions endorsed and funded Dayton’s gubernatorial campaign.

“Instead of steady pay raises across the board,” Hunter said, “the SEIU has lobbied for paid time off (PTO) and training stipends that are hard to navigate and of little use to most PCAs, especially when we care for a family member. The SEIU has made it hard to get the coverage we need. This rule change from Trump should help focus PCAs on whether the SEIU has helped or harmed the program. We have a choice, and I hope PCAs choose not to pay the SEIU.”

Powerful unions such as the SEIU worked with “Blue State” governors starting in the 1990s to turn welfare into revenue by declaring in-home care providers paid under Medicaid “public employees.” (The Center worked with in-home child care providers to decisively defeat an attempt by Governor Mark Dayton and AFSCME to unionize them in 2016.) Currently, the State of Minnesota deducts a portion from Medicaid payments to in-home care providers and gives it to the SEIU. This money is intended to help keep America’s disabled out of institutions.

In turn, those same unions finance the election of lawmakers, almost exclusively Democrats, as well as left-leaning lobbying groups such as Planned Parenthood. The rule change means that, while the SEIU will remain certified for now, the union will have to collect its own dues. And Trump’s ruling means those dues should be declining rapidly.

In 2014, the U.S. Supreme Court ruled (Harris v. Quinn) that PCAs paid under Medicaid were not “full-fledged” public employees, so they could not be forced to pay union fees. In 2018, the Court went further, saying that not even bona fide public employees could be forced to fund a workplace union (Janus v. AFSCME). The problem is that most PCAs do not follow the Supreme Court; they are too busy caring for the disabled, so they might be paying union dues and not know it.

The SEIU charges its low-income members three percent of gross wages up to $948 a year, more than other union members are assessed. According to estimates based on federal filings, the SEIU skimmed $4.7 million from Minnesota PCAs in 2016, with about $150 million a year being diverted in a dozen states. Since 2014, $1.4 billion has been diverted by state governments into union coffers. But what has the SEIU done for PCAs?

Greene, the Lakeville mother of a disabled daughter and a PCA, traveled to the nation’s Capital in 2018 to ask lawmakers to end the dues-skimming scheme and is thrilled about the rule change but cautious. “This is great because it protects PCAs who get tricked into paying dues. But the union is still certified and speaks for all PCAs, even people like me who do not belong to the union, at both the state Capitol and in Washington, D.C.”

The rule was scheduled to take effect on July 5, 2019, though California and other states (not including Minnesota) have filed suit to stop the rule change. Congressional Democrats, including Betty McCollum (D-4th District), introduced legislation to deprive the administration from spending any money to enforce the rule. Congressional Democrats called it “an attack on women, especially women of color.” That was an odd characterization given that caregivers are mostly family and friends of the disabled. McCollum has received substantial contributions from SEIU and AFSCME (see table).

The Center is working to notify PCAs of the rule change and to determine whether states are complying. If Minnesota fails to stop taking money out of PCA paychecks and depositing it in the SEIU’s bank account, the Center will ask the Trump administration to withhold Medicaid funds until the rights of PCAs are honored and the Social Security Act is enforced.