Biden administration officials at the Department of Health and Human Services (HHS) want to renew an Obama era regulation that allowed labor unions to skim an estimated $1 billion from Medicaid payments to home healthcare providers.
The proposal “will place a federal stamp of approval on abusive state and union practices to pressure, mislead, and ultimately lock home-care providers into assigning portions of their Medicaid payments to union special interest groups and associated funds,” the National Right to Work Legal Defense Foundation (NRTWLDF) said in a comment on the plan.
“Such assignments are generally irrevocable for a year or more, resulting in the diversion of Medicaid payments to third parties for political advocacy and other purposes over the express objections of home-care providers,” the NRTWLDF said.
The Biden proposal from HHS’s Centers for Medicare and Medicaid (CMS) would rescind a 2018 Trump administration rule that upheld the intent of Congress to deny third-parties, including unions, access to Medicaid payments to providers of home-based health care for disabled persons.
Despite a federal law—Section 1902(a)(32) of the Social Security Act—that specifically prohibited assignment of payments to third-parties, the Obama administration adopted a special exemption in 2014 that permitted them for labor unions. The only exceptions recognized by the law cover court orders for wage garnishments, child support orders, and judgements for debts owed to states.
The U.S. Supreme Court also ruled in 2014 that compulsory union payments violate the First Amendment rights of home healthcare workers who prefer not to support union activities.
Home healthcare providers in more than a dozen non-right to work states faced requirements that a portion of their payments be provided to fund union activities, according to NRTWLDF.
Those states were able to enforce such requirements by automatically deducting such fees from Medicaid payments even though doing so violated federal law regarding Medicaid funds.
The skimming equaled an estimated $200 million annually prior to the Trump rule taking effect, according to the State Policy Network. There are more than 400,000 home healthcare providers in the U.S.
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