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The Trump administration is taking steps to prevent labor unions from withholding dues for home healthcare workers from their Medicaid payments, an Obama-era innovation that many observers believe is illegal.
On Tuesday, the Centers for Medicare and Medicaid Services (CMS) proposed undoing a 2014 rule allowing states to skim public-sector union dues from Medicaid payments to independent home healthcare providers on the theory that those providers are de facto public employees — a privilege that has netted unions anywhere from $71 million (CMS’ estimate) to $200 million (State Policy Network) annually.
Law - Medicaid - Providers - Part - Payments
“The law provides that Medicaid providers must be paid directly and cannot have part of their payments diverted to third parties outside of a few very specific exceptions,” Tim Hill, acting director for the Center for Medicaid and CHIP Services, said in a press release. “This proposed rule is intended to ensure that providers receive their complete payment, and any circumstances in which a state does divert part of a provider’s payment must be clearly allowed under the law.”
Independent home-care workers, who often care for family members with severe, chronic conditions, are eligible for hourly wages and training through Medicaid. While Medicaid shouldn’t exist at all under our Constitution, paying for home care costs taxpayers considerably less than paying for institutional care, so in this sense the home-care subsidy is a bargain.
Years - Public-sector - Unions - State - Governments
In recent years, public-sector unions have managed to convince several state governments that home caregivers should be classified as public employees and thus that the state should force them to join unions and have dues withheld from their Medicaid payments. This wasn’t exactly a hard sell given that those governments were controlled by Democrats, who stood to benefit from unions’ swelling coffers.
In Minnesota, for instance, Governor Mark Dayton, a Democrat, first issued an executive order declaring home-care providers state employees....
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