The CMS finalized a rule on Thursday to no longer allow unions for home healthcare workers to get dues paid via state Medicaid payments.
The rule, which overturns a 2014 rule, no longer allows a state to divert payments from Medicaid to anyone but the provider with few exceptions. The agency charges that the 2014 rule that allowed unions to get dues from payments stretches the meaning of the federal statute and must be struck down.
"This final rule is intended to ensure that providers receive their complete payment, and that any circumstance where a state redirects part of a provider's payment is clearly allowed under the law," CMS Administrator Seema Verma said in a statement.
The final rule, which was originally proposed in July 2018, maintains that it does not prohibit home healthcare workers from joining a union.
"The effect of this final rule is the elimination of one method of getting payment from A to B," the final rule said. "It in no way prevents healthcare workers from purchasing health insurance, enrolling in trainings, or paying dues to a union or other association."
The rule is the latest in a larger fight over union rights with the Trump administration. Some critics charge that the rule is a backdoor attempt to curb the power of unions because it creates an extra step for workers to pay union dues.
"Why can I and most workers have payroll deductions that can contribute to health insurance, my retirement savings, my union dues, but these workers can't?" asked Caitlin Connolly, director of social insurance for the pro-union advoaccy group National Employer Law Program. "We know that most union members and workers like teachers, firefighters and police officers are also making these contributions through payroll deductions."
Advocates of right-to-work laws, which state that an employee in a unionized workplace doesn't have to pay dues, say that the CMS rule protects taxpayer dollars.
"While the rule will still need to be robustly enforced, today's announcement is an encouraging action toward stopping union bosses from unlawfully using public payment systems to intercept tax dollars intended for providers caring for those in need," said Mark Mix, president of the National Right to Work Legal Defense Foundation, a nonprofit that pursues litigation in favor of right-to-work.
