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‘It’s a sexist and racist attack’: Trump’s regulation to weaken home health care unions takes effect

A subtle, but important technical change.

LOS ANGELES, CA - APRIL 14: More than a thousand L.A. County homecare workers march past the county administration building downtown to call for a hike in the minimum wage to $15 per hour. Their efforts to secure better pay may suffer a setback should a Trump administration rule go into effect this week. (Photo by Luis Sinco/Los Angeles Times via Getty Images)
LOS ANGELES, CA - APRIL 14: More than a thousand L.A. County homecare workers march past the county administration building downtown to call for a hike in the minimum wage to $15 per hour. Their efforts to secure better pay may suffer a setback should a Trump administration rule go into effect this week. (Photo by Luis Sinco/Los Angeles Times via Getty Images)

Adarra Benjamin earns $13.48 an hour as a home health worker — a wage that includes a 48-cent-per hour raise thanks to her union, Service Employees International Union (SEIU) Healthcare Illinois.

Benjamin, who’s 25 years old and lives in Chicago, also received $1,200 in backpay this year after Illinois agreed to the raises back in 2017. She was one of more than 49,000 employees statewide to receive this long-overdue backpay.

“After becoming a member… I truly understood what it meant,” said Benjamin, “We are the union — the workers in general are the union — and understanding that if we don’t come together, we don’t have a voice. If we don’t have a voice, no one understands where the hard work and the dedication is coming from… no one understands what it takes to take care of yourself and other people.”

When she’s isn’t caring for her great-grandmother — cooking and cleaning — Benjamin assists a client with cerebral palsy — brushing her teeth or physically putting her to bed. Her two jobs demand that she work roughly 52 hours per week. 

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But a regulation that takes effect on Friday would bar someone like Benjamin, whose work is paid directly by Medicaid, from having her union dues automatically deducted from her paycheck. It’s a subtle but important technical change, as it’ll likely load more administrative burden onto workers who assist older adults and people with disabilities in their homes.

“I don’t like it,” said Benjamin, of the regulation. “It’s a sexist and racist attack.”

The regulation makes life more difficult for a specific sect of public-sector workers, said Caitlin Connolly, of the workers’ rights advocacy group, National Employment Law Project.

“We can’t ignore the fact that this regulation — this attack — on these workers has racist implications,” Connolly told ThinkProgress. “This is a workforce that’s majority women of color and the fact that this administration thinks that they can take their rights away from them by creating a false scenario is blatantly racist.”

In the more typical arrangement, the deduction of union dues, much like similar deductions by which employees pay into their health insurance or retirement savings, are automatically taken out of a worker’s paycheck once they agree to participate. (The Supreme Court decision, Harris v. Quinn, requires workers to opt in and explicitly state they want to participate in a union before the organization can collect dues.) Other public sector workers who are part of a union, such as firefighters or police officers, pay their dues through payroll deductions of earnings.

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But the Trump administration is banning this practice for some home health aides and is requiring them to pay dues separately, in some instances by mail. People of color make up 60% of all home care workers; over one-quarter are immigrants; and roughly half have completed no formal education beyond high school, according to research by the Paraprofessional Healthcare Institute (PHI).     

The Trump administration maintains that federal law does not permit Medicaid dollars to be diverted in this fashion. Groups like National Federation of Independent Businesses argue that this rule prevents unions from using taxpayer dollars to pay for lobbying.

“People don’t get to choose the source of their pay,” said Connolly. “And the fact that, as a society, we make investments through our Medicaid-funded programs to make sure that individuals with disabilities and older adults can remain in their homes — that should not and does not at all detract from these workers rights.”

The regulation is just the latest example of the administration undermining the efforts of organized labor. Last year, President Donald Trump issued executive orders that make it easier to fire federal employees and weaken their ability to collectively bargain. When a federal court struck down key provisions of those orders, the administration achieved similar goals through workarounds.

The benefits that have accrued to home health aides through unionizing are well-documented: home care workers helped create the nation’s first social insurance for long-term care in Washington state; workers negotiated a wage increase to $16.10 per hour by July 2021 in Massachusetts; and workers secured training programs for improved delivery of care in Washington state, Oregon, Connecticut, Massachusetts, Illinois, and some counties in California.

“If these policymakers were serious about making home care accessible and available to all people with disabilities and all older adults, they would be investing in this workforce right now not attacking them because turnover is a huge,” said Connolly.

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The median annual income for home care workers is $15,100 in 2017, and the turnover rate ballooned to 82 percent in 2018. Over 2.1 million home care workers provide health care, and the demand will likely grow as the population of people 65 and older will double; the elderly population is projected to be 88 million in 2050.

States where workers are unionized are fighting back. California Attorney General Xavier Becerra, along with attorneys general in four other states, are suing the administration in federal court to block the rule. The case is pending. It’s unclear if the changes to how fees are collected will impact union membership or finances, but workers remain optimistic.

“This is a way to break us, and to not only show us how little they truly care about us but show us how little they think we care about ourselves,” said Benjamin. “But I’m sure the union will come out strong and members understand how valuable it is to still come together.”