Politics & Policy

Medicaid Dollars Should Go to Those Who Need Them, Not Big Labor

(Photo: Dreamstime)
The program is meant to help cover Americans’ health-care costs, but has been hijacked by giant, predatory unions and their Democratic allies.

The American people are big-hearted, and our prosperity has made it possible for us to be generous to those in need. While Congress is right to scrutinize the ever-ballooning entitlement state, there is a wonderful Medicaid program that merits support: home-based services for the disabled. But it is under assault, hijacked to fund politics in states such as Minnesota.

Kris Greene’s youngest child, Meredie, was born with a rare genetic condition, Rubinstein-Taybi syndrome (RTS). Meredie, a delightful young lady, requires full-time supervision. The Greenes have gratefully accepted help from a variety of programs over the years to keep Meredie at home. When Meredie became an adult, Kris registered as her paid caregiver under Medicaid, and as such received a modest hourly wage set by the state legislature to subsidize the cost of home care.

So far, so good: For a fraction of the cost of institutional care, Medicaid paid Kris to tend to Meredie, whose health stabilized as a result. But in 2011, a representative from the Service Employees International Union (SEIU) came knocking at the Greenes’ door to aggressively pitch union membership to Kris. She was confused about why the union would ask her to sign a card asking for representation as a home-care provider.

What she later found out made her angry: Governor Mark Dayton had issued an executive order declaring that home-care providers were “state employees” but only for the purposes of collective bargaining. This meant that though she could not be forced to join the SEIU, she had to pay an “agency” fee, set by the union at 85 percent of dues, to cover the cost of bargaining.

Kris successfully sued Governor Dayton, getting a court to find his order unconstitutional. But in 2013, with a Democratic majority in the legislature, Dayton signed a bill that subjected providers like Kris to unionization. He cynically characterized his position as fighting for “low-wage health care workers.” In an election marked by low turnout, misinformation, and bullying, the SEIU became the exclusive representative of thousands of providers spread across Minnesota. The SEIU would set dues at a whopping 3 percent of wages, up to $948 a year — and the government would collect them for the union.

Dayton was following in the footsteps of a number of Democratic governors across the country who have successfully transferred money from Medicaid and other welfare programs to key political supporters such as the SEIU and the American Federation of State, County and Municipal Employees (AFSCME).

There is a wonderful Medicaid program that merits support: home-based services for the disabled. But it is under assault, hijacked to fund politics in states such as Minnesota.

In nine states, child-care subsidies for low-income kids are used as a legal pretense for unionizing home-based child-care providers. In Washington state, even foreign-language interpreters, who are paid with welfare funds to help refugees and immigrants navigate legal and medical needs, are unionized as public employees.

The State Policy Network, a coalition of state-based think tanks (including my employer), estimates that the SEIU and AFSCME are skimming about $200 million a year from Medicaid funds, and another $50 million a year from child-care subsidies offered through the Temporary Assistance for Needy Families program. The bulk of that cash is spent helping politicians like Dayton, not providers.

Kris Greene says the SEIU has done nothing for her family but cause heartache and worry. Before unionization, Kris got regular wage increases and all the training she needed from the state. Now the SEIU, which “bargains” with the Dayton administration, has taken over the training, and instead of a wage increase, Kris gets a few days of PTO and holiday pay, absurd benefits when you are caring for a family member at home.

In 2014 another provider, named Pamela Harris, sued Governor Pat Quinn of Illinois, arguing that forcing her to pay even an agency fee violated her First Amendment rights. Like Kris, Pam has a child with Rubinstein-Taybi syndrome. She took her case all the way to the U.S. Supreme Court, which ruled that because providers are not “full-fledged” public employees, the First Amendment prohibits the collection of agency fees from those who choose not to join a union. (An upcoming case, Janus v. AFSCME, will give the Court an opportunity to overturn on similar grounds a 1977 decision that forces “full-fledged” public employees to pay agency fees to unions.)

As a result, providers can “opt out” of paying agency fees, but because the unions establish and control the process by which one opts out, it is often very hard to do so. Moreover, even though Kris and Pam do not have to pay any fees, the union still speaks for them, exclusively representing their needs before Congress and the states. That is why Kris is leading a decertification effort that has so far produced over 10,000 signatures from providers asking to get out of the SEIU. Governor Dayton has used the power of the state to fight her every step of the way.

Luckily for her, help may be coming from Washington, D.C. Representative Cathy McMorris Rodgers (R., Wash.) has stepped in to protect these providers and Medicaid. The issue is personal for McMorris Rodgers. Her son, Cole, was born in 2007 with Down syndrome, and she has been a champion for the disabled in Congress. She is drafting legislation that would prohibit using Medicaid funds to pay union dues. If the legislation becomes law, unions would still represent providers in states such as Minnesota (unless they are decertified), but they would have to collect their own dues, dealing the entire scheme a huge blow.

That would be a victory not just for people such as Kris and Pam, but for everyone with an interest in seeing welfare dollars directed to those in need — and not into the coffers of union behemoths and their Democratic allies.


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