By Sam Han and Will Swaim
Home caregivers serving Medicaid patients in California are being shortchanged and, chances are they don’t even know it.
Medicaid pays for elderly and disabled individuals who need support with activities of daily living to receive support at home from a caregiver. But California and 10 other states deduct union dues from caregivers’ Medicaid payments, in many cases without the knowledge or approval of patients and their caregivers. Given the fact that many caregivers work in their own homes caring for loved ones and relatives, unions typically have little role to play in exchange for the dues they collect.
In this way, unions skim an estimated $200 million each year in dues from Medicaid payments before those checks ever reach the patients they were intended to help. In short, dues skimming takes funds meant to provide care for our country’s most vulnerable people — the elderly, sick, poor, and disabled — and sends it to a politically favored special interest group that provides no services to the needy.
Federal reports filed by SEIU 2015, one of the two unions representing Medicaid caregivers in California, indicate that nearly 60 percent of the funds it collects in dues are spent on political work and other activity unrelated to representing caregivers.
Some caregivers — often parents looking after their disabled children or family members taking care of other relatives — have challenged the legality of forcing in-home providers to pay union dues just so they can care for a loved one. Illinois caregiver Pam Harris took her case all the way to the U.S. Supreme Court. Ruling in Harris’ favor, the Court called dues skimming a “scheme” and said unions couldn’t force caregivers to pay dues.
Unfortunately, unions have found ways to get around the decision and keep home caregivers paying dues. Often, they impose onerous hoops caregivers must jump through to resign, or they enact confusing and arbitrary rules intended to keep the dues money flowing. For instance, Oregon caregivers who belong to SEIU 503 may leave the union only during a 15-day annual period that varies by member. California caregivers are subjected to a half-hour-long union membership pitch before they’re allowed to work. Caregivers in Minnesota have alleged the union forged signatures on membership cards.
This piecemeal approach isn’t working for caregivers, and it’s time for Washington to finally put a stop to dues skimming so caregivers can focus on serving their patients, not overcoming hurdles to get out of the union. The U.S. Department of Health and Human Services could fix the issue by clarifying administrative rules to prevent states from diverting Medicaid dollars to unions. Congress could also act to stop this abuse.
Getting states out of the union dues collecting business would help protect the integrity of Medicaid for current and future patients while also upholding the rights of caregivers who don’t want to join a union. Most importantly, it would ensure the funds are spent on providing services to the needy, as originally intended. At the same time, nothing would prevent caregivers who desire to remain union members from paying union dues on their own.
California has an estimated 300,000 or more in-home caregivers serving Medicaid clients. Many, if not most, of these people are unaware they belong to a union and are having hundreds of dollars per year skimmed off their Medicaid payments for union dues, but that doesn’t make dues skimming right.
Medicaid patients are among the most vulnerable around us. Let’s not allow them to continue to be victimized by unions.
Samuel Han is the California Director of the national Freedom Foundation. Will Swaim is president of the California Policy Center. Both organizations work to advance free-market and limited-government principles. This commentary appeared first in the Orange County Register.