Home care workers are often family members that look after a medically impaired parent, spouse, or child who would otherwise require expensive professional care or institutionalization. Such in-home care services qualify for financial assistance from the joint federal-state Medicaid program.

In 2012-13, the Service Employees International Union (SEIU) and the American Federation of State, County and Municipal Employees (AFSCME) – two of the nation’s largest labor unions – spent significant money lobbying Vermont lawmakers to allow the unionization of independent home care workers. The SEIU spent $200,000 on Vermont political campaigns, while the AFSCME poured $35,000 into political and legislative activities.

In May 2013, Democrat Governor Peter Shumlin signed Act 48, which passed in the Vermont Legislature along party lines. Capitalizing on its local advantage, AFSCME (that has operated in the Green Mountain State since 1953) won against newcomer SEIU in securing the sole and exclusive representation of Vermont’s 7,500 home care workers. The local union is called Vermont Home Care United (AFSCME Council 93, Local 4802).

In-home caregivers are “employed” by the patient and not the state. Therefore, the rights and benefits accompanying public sector union membership, e.g. collective bargaining, job security, and workplace safety, do not apply. Indeed, the bitter conflict between SEIU and AFSCME, in the aftermath of Act 48, betrayed the law’s true intention.

Organizing family caregivers (as with any group of workers) creates a steady revenue stream from collecting membership dues. Union leaders funnel this capital primarily into Democratic Party politics at the local, state and federal level. The National Institute for Labor Relations Research reports that organized labor spent $1.713 billion on political activities, predominantly supporting Democrats, during the 2016 election cycle.

Gone are the days when labor unions represented workers’ interests; now Big Labor represents a powerful player in Democratic politics bent on increasing membership, its financial reservoir, and ability to elect and influence politicians. For example, Vermont and ten other blue states deduct membership dues and/or agency fees (in some cases, without notice) from Medicaid payments intended for home care workers, and siphon off these funds to unions.

To provide a legal basis for this scheme, known as “dues skimming,” the Obama Administration created a new rule in January 2014 enabling states to divert Medicaid monies to third parties, i.e. labor unions and insurance companies. Unions skim an estimated $200 million annually from home care workers.

In June 2014, the U.S. Supreme Court ruled in Harris v. Quinn that home care workers are not full-fledged public sector employees, and thus union bosses could not compel non-union members to pay “agency” or “fair share” fees, as it violates freedom of speech and freedom of association rights protected by the First Amendment. Nevertheless, unions continued imposing agency fees on all workers covered by a collective bargaining agreement, even if s/he had opted out of union membership.

Last week, the Centers for Medicare & Medicaid Services announced the roll back of the 2014 Obama-era rule, stating that these illegal arrangements violate Medicaid’s purpose to financially assist poor, elderly, and disabled Americans. Vermonters can find some solace in knowing that dues skimming practiced by our state government and Vermont Home Care United is neither coercive nor covert.

As per the collective bargaining agreement, effective July 1, 2018, the state can subtract union dues (2 percent) if the home care worker elects to join the union and authorizes such wage deduction. Further, the state can make donations from a worker’s Medicaid wages to the union’s political action fund (PEOPLE fund), or to another legal PAC organized by AFSCME, if requested in writing by the individual. The Scott Administration will need to cease these deductions, albeit voluntary, when the CMS rule change takes effect in three weeks. Consequently, Vermont home care workers should expect to receive higher Medicaid payments soon.

The CMS rulemaking comes at the heels of another strike against union cash-grab schemes. In the June 2018 landmark case, Janus v. AFSCME Council 31, the nation’s highest court decided that the First Amendment precludes non-union members from paying public sector union dues, and thereby subsidizing union speech and activities to which they may “strongly object.”

By observing United States constitutional and labor laws, the judicial and executive branches of the federal government have granted more Americans the freedom and right to work, and ensured that our taxpayer funds support those, amongst us, in gravest need. These measures will drain the bloated coffers of Big Labor. Expect retaliation.

Meg Hansen is executive director of Vermonters for Health Care Freedom, a nonprofit committed to free-market reforms in American health care.

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(1) comment

realistic

It's not clear if you're confused or deliberately playing really loose the facts. First, it's a *proposed* rule change that would only take effect after it moves through the review process - not in three weeks at all. Second, it only has the power to return to pre-2014 status quo, when voluntary payroll deduction had *already been in place for decades*. Third, you note this is each worker's choice and didn't take effect until 7/1/18 - it makes no sense that people will see some big increase in their "Medicaid payments" since these union members have chosen to pay their dues this way. Be honest and call what it is, Meg - the federal government is reaching into people's paycheck to prohibit them from spending their money as they choose. Maybe you like Trump, but are you really okay with the next president deciding how anyone earning Medicaid dollars can and can't choose to spend their wages?

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