{"id":441383,"date":"2025-12-12T01:59:15","date_gmt":"2025-12-12T01:59:15","guid":{"rendered":"https:\/\/www.europesays.com\/us\/441383\/"},"modified":"2025-12-12T01:59:15","modified_gmt":"2025-12-12T01:59:15","slug":"patients-come-last-as-union-angles-for-200m-a-year-medicaid-payday","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/441383\/","title":{"rendered":"Patients come last as union angles for $200m-a-year Medicaid payday"},"content":{"rendered":"

New York has been ground zero for one of the worst taxpayer abuses in the history of Medicaid, and now\u00a0it\u2019s poised to get much worse<\/a>: A labor union plans to skim hundreds of millions of dollars from Medicaid in New York.<\/p>\n

Albany\u2019s Consumer-Directed Personal Assistance Program was set up to help people with serious disabilities avoid costly full-time care in nursing homes.<\/p>\n

The idea was to pay caregivers with funds from Medicaid (the joint state-federal health-care program for the poor and disabled that now accounts\u00a0for about 10% of federal spending) to help patients live independently, saving taxpayers\u2019 money.<\/p>\n

But lax rules, bad actors and social media converged to make CDPAP\u2019s costs balloon.<\/p>\n

Subway ads and TikTok videos showed people how they could get \u201cfree\u201d money to care for a relative or friend.<\/p>\n

Hundreds of middleman agencies sprang up to cash in, handling payroll and paperwork on each new sign-up.<\/p>\n

By last year, CDPAP was paying about 400,000 people.<\/p>\n

The cost: roughly $11 billion \u2014 with federal taxpayers picking up most of the tab.<\/p>\n

Its massive size made policing CDPAP\u2019s abundant fraud impractical. <\/p>\n

One state probe found multiple people getting paid to \u201ccare\u201d for a single patient \u2014 who lived in South Asia.<\/p>\n

Gov. Kathy Hochul, ostensibly concerned about the price tag, got state lawmakers to eliminate most CDPAP middlemen<\/a>.<\/p>\n

But now the other shoe is dropping: 1199 SEIU, the state\u2019s largest health-care union, is angling to unionize CDPAP workers<\/a>, leaning on Public Partnerships LLC (a\/k\/a PPL) , the state\u2019s new head middleman, to do so.<\/p>\n

This isn\u2019t your granddad\u2019s idea of a labor union.<\/p>\n

It\u2019s almost the complete opposite: CDPAP caregivers don\u2019t work together.<\/p>\n

They don\u2019t have one boss, but a couple hundred thousand \u2014 the patients.<\/p>\n

And they work in extremely intimate settings, for patients who must literally trust them with their lives.<\/p>\n

Those patients should, and must, have the power to hire, train or fire them.<\/p>\n

What would 1199 bring to the table in this scenario? It\u2019s already up to Albany to boost providers\u2019 pay or benefits.<\/p>\n

Would 1199 push to limit how \u201cconsumer-directed\u201d CDPAP is, by imposing union discipline rules that make it harder to fire bad employees?<\/p>\n

Would the union try to tell CDPAP patients with profound disabilities that they no longer decide whether a caregiver gets a key to their home, or can dress and bathe them?<\/p>\n

It sounds absurd \u2014 but these questions need to be posed, because unionizing CDPAP is a cash grab first; the consumers are an afterthought.<\/p>\n

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Similar scenarios have played out in several states, including New York, in recent decades.<\/p>\n

Subsidized child-care providers, many of whom watched their neighbors\u2019 kids at home, were surprised in 2009 when unions including the United Federation of Teachers began taking a cut of their state payments, following a sham mail-ballot election in which few providers voted.<\/p>\n

Elsewhere, SEIU and a few other unions started skimming from Medicaid payments given to parents caring for children with disabilities.<\/p>\n

The US Supreme Court cracked down in\u00a02014,\u00a0ruling that such caregivers are answerable to individual consumers, not to state agencies, and can\u2019t be forced to pay a union.<\/p>\n

But Hochul\u2019s law makes PPL a private \u201cemployer,\u201d so unionizing its caregivers would mean 1199 could force every one of them to pay\u00a0a 2% tribute\u00a0\u2014 or get fired.<\/p>\n

At the current number of CDPAP caregivers, 1199 would snag another $200 million a year.<\/p>\n

PPL is likely cooperating because doing so is something akin to buying protection from mobsters.<\/p>\n

Everyone in Albany has seen the 1199-financed attack ads lobbed at governors and other state officials who question the size or efficacy of Medicaid.<\/p>\n

If this unionization scheme succeeds, such public lobbying would explode.<\/p>\n

The union won\u2019t just have an incentive to keep the caregiver sign-up rules loose \u2014 it will have a fiduciary\u00a0duty\u00a0to keep wasting public money, and to pressure lawmakers for more.<\/p>\n

It\u2019s utterly unprecedented in scale and scope.<\/p>\n

The fact that management is teaming up with labor to further bilk taxpayers, seemingly with Hochul\u2019s blessing<\/a>, means Washington must act.<\/p>\n

During President Donald Trump\u2019s first term, federal regulators issued rules meant to shield Medicaid recipients from dues-skimming schemes crafted by governors and their union boosters.<\/p>\n

The Biden administration promptly reversed those fixes.<\/p>\n

This time, the feds must first focus on tightening the patient eligibility rules of CDPAP-like programs, to reserve this care for people who truly need it.<\/p>\n

That would fit neatly in the next government funding bill<\/a>, since federal taxpayers are losing money every day the Albany spigot stays open.<\/p>\n

It would also help trim some fat from the state budget, where Medicaid is now the biggest single expense.<\/p>\n

But if 1199\u2019s ploy proceeds, New York taxpayers will be stuck supporting the nation\u2019s most costly Medicaid program \u2014 and the union that\u2019s keeping it that way.<\/p>\n

Ken Girardin is a fellow at the Manhattan Institute.<\/p>\n","protected":false},"excerpt":{"rendered":"New York has been ground zero for one of the worst taxpayer abuses in the history of Medicaid,…\n","protected":false},"author":3,"featured_media":441384,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5122],"tags":[20184,5229,12049,15669,5371,3170,405,403,5226,5225,5228,5227,1269,202840,4573,39749,67,586,132,5230,68,2969],"class_list":{"0":"post-441383","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-new-york","8":"tag-albany","9":"tag-america","10":"tag-federal-budget","11":"tag-government-spending","12":"tag-kathy-hochul","13":"tag-medicaid","14":"tag-new-york","15":"tag-new-york-city","16":"tag-newyork","17":"tag-newyorkcity","18":"tag-ny","19":"tag-nyc","20":"tag-opinion","21":"tag-seiu-1199","22":"tag-state-budget","23":"tag-unions","24":"tag-united-states","25":"tag-united-states-of-america","26":"tag-unitedstates","27":"tag-unitedstatesofamerica","28":"tag-us","29":"tag-usa"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115704127085152897","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/441383","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=441383"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/441383\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/441384"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=441383"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=441383"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=441383"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}