They’re at it again.
For at least the third time in a year, union-backed lawmakers in the U.S. House of Representatives are attempting to keep on life support the deduction of union dues from Medicaid payments to home caregivers in the face of efforts by the U.S. Department of Health and Human Services (HHS) to put a stop to the illegal practice.
These caregivers provide in-home assistance with activities of daily living to Medicaid-eligible persons with functional disabilities. Often the caregivers are related to or have pre-existing close personal relationships with their clients.
As Medicaid providers, caregivers are protected by a decades-old federal law requiring that they receive full payment for the services they furnish to Medicaid beneficiaries.
In open defiance of this law, at least eight states — including three in which the Freedom Foundation operates, namely Washington, Oregon and California — divert portions of caregivers’ Medicaid payments to labor unions. In Washington, tens of thousands of caregivers lose 3.2 percent of their wages to Service Employees International Union Local 775 in Seattle.
Freedom Foundation research documented that, in 2017 alone, these eight states illegally deducted about $150 million in union dues from the Medicaid payments of 350,000 caregivers.
While union dues payment is technically voluntary for home caregivers thanks to the U.S. Supreme Court’s 2014 decision in Harris v. Quinn, the dues deduction process remains incredibly coercive in practice, with unions even forging caregivers’ signatures on membership forms.
Thankfully, last year HHS began taking action to stop states from continuing the illegal deductions. Unsurprisingly, the offending states and unions have filed a lawsuit against HHS in their preferred venue — the San Francisco-based U.S. District Court for the Northern District of California — to keep the deductions alive.
But regardless of what happens at the District Court, the case will almost certainly reach the 9th Circuit Court of Appeals or even the U.S. Supreme Court. And the law is quite clear.
Consequently, union-aligned lawmakers in Congress are seeking to use the time bought by the lawsuit to keep the practice alive by other means.
Section 247 of H.R. 7617 — which would fund HHS, among other agencies, for 2021 — would bar HHS from using any federal funds to stop illegal union dues deductions from Medicaid and enforce the law requiring direct payment to caregivers.
For the second time, Rep. Dan Newhouse, who represents the fourth congressional district in central Washington, spoke out against this special-interest giveaway.
“Mr. Speaker, one in five households with a disabled family member falls below the federal poverty line. These families rely on home healthcare providers — who are often family members of the disabled — to care for them and to improve their quality of life. These providers receive modest compensation for their efforts, provided by dedicated state Medicaid dollars.
For decades, federal law has required that Medicaid providers be paid directly and in full for the services they provide. However, some states, including my own home state of Washington, have been withholding union dues via payroll deductions from payments to Medicaid-subsidized home caregivers.
In many cases this is done without the knowledge or the consent of the caregiver, and it is a clear violation of the law. And this is no small problem. In 2017 alone, $150 million was diverted to unions for Medicaid payments to 350,000 caregivers.
Fortunately, last year the Centers for Medicare and Medicaid Services finalized a rule to stop this predatory practice that takes money out of the pockets of in-home providers. However, language in the bill would defund implementation of this rule and allow states to continue to circumvent the federal law. My amendment strikes Section  of the bill to ensure that CMS can enforce the law and protect home health care providers from having their Medicaid payments diverted to third parties.
Mr. Speaker, let me be clear. Ending this illegal deduction does not prevent caregivers from joining unions if they wish. Rather, it empowers them by giving them the choice to do so. My amendment gives them that choice.”
Unfortunately, Newhouse’s amendment — offered as part of a package of amendments to the budget bill — was rejected by majority Democrats and the bill passed the House along party-lines.
Nevertheless, at this stage the bill’s passage is primarily posturing by House leadership, and it remains to be seen what agreement the Democrat-controlled House and Republican-controlled Senate will reach to continue funding the federal government.
Hopefully, thanks to Rep. Newhouse’s stand, the “predatory” practice of skimming union dues from caregivers’ Medicaid payments is a bit less likely to ultimately become law.