Health Aides Want Union Hands Off

Providers ask court to protect admin rule against dues skimming

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June 23, 2019

Home health care providers are asking a federal judge in California to uphold a Trump administration regulation that would block unions from skimming money from Medicaid reimbursements.

In May, the Department of Health and Human Services's Centers for Medicare and Medicaid Services adopted a new regulation to prohibit states from taking money from caregiver reimbursements and giving it to third parties. The regulation took direct aim at several state policies that siphoned money from health aides, many of whom are caring for disabled relatives, and gave it to labor unions.

"This final rule removes the regulatory text that allows a state to make Medicaid payments to third parties on behalf of an individual provider for benefits such as health insurance, skills training, and other benefits customary for employees," the regulation says. "State Medicaid programs are responsible for ensuring that taxpayer dollars are dedicated to providing healthcare services for low-income, vulnerable Americans and are not diverted in ways that do not comply with federal law."

The rule sparked a lawsuit from California, Connecticut, Massachusetts, Oregon, and Washington. The states are now seeking to stop it from going into effect. Several caregivers in those states, however, are seeking to protect the rule and ensure that they receive their full reimbursements from Medicaid. The lawsuit pits the states' claims against the federal government, but the aides argue their own input is needed to ensure that their interests are represented in the case.

"Providers have financial and constitutional interests in stopping the unwanted diversion of monies from their Medicaid payments to subsidize union advocacy," the filing says. "No existing party represents the Movant Providers' interests with respect to their counterclaim that California, Oregon, and Washington are depriving them of their right to direct payment."

The providers are asking to intervene in the case based in part on their personal financial interest. While the federal government may have money at its disposal to deal with litigation and diversions in reimbursement, health aides say they will continue "having monies seized from Medicaid payments owed to them, and remitted to unions, against their will and with no recourse."

The brief was a collaboration between the National Right to Work Legal Defense Foundation and the Washington state-based Freedom Foundation.

"Providers are right to oppose this lawsuit's blatant attempt to enable union bosses to skim union dues in violation of federal law," National Right to Work Foundation president Mark Mix said in a statement. "Nothing in this rule stops union officials from collecting voluntary dues from voluntary union members, it just says that taxpayers and government shouldn't act as the bagman for such dues payments."

Ten caregivers are involved in the suit. Freedom Foundation labor expert Maxford Nelsen praised them for their fortitude in the face of union opposition.

"The determination of these caregivers is truly inspiring," Nelsen said in a statement. "It takes a lot of guts to stand up to the repeated attempts of thuggish unions like SEIU and AFSCME and their political cronies to bully and exploit those selflessly caring for the most vulnerable among us. Yet caregivers continue to courageously fight back."

The lawsuit is scheduled to appear before the United States District Court for the Northern District of California on July 25.