The BBBA’s expansion of federal Medicaid funding for care to adults with disabilities through home and community-based services (HCBS) could steer billions of dollars in Medicaid funds to unions representing home care aides, such as the Service Employees International Union and the American Federation of State, County, and Municipal Employees.
As a condition of receiving the federal funding, states must implement changes to their HCBS programs designed to encourage the unionization of home care aides and to allow unions to forcibly skim union dues from their Medicaid payments.
This practice is already standardized in states like Washington, and the result is that the unions representing these home care providers rival teachers’ unions in money and power.
The Medicaid expansion provisions in their current form – with the incentives for unionization – would use tax dollars to subsidize unions’ wide-ranging political and electoral goals. These components of the BBBA are:
· Bad for taxpayers, from whom the money is extracted to fund Medicaid
· Bad for caregivers, who could better use that money to care for their ailing loved ones rather than pay union dues
· Bad for the political process, by nationalizing a policy practiced in the most left-leaning and union-controlled states in the country