States arguethat unionized workers would be harmed and, in the words ofConnecticut, “undermined,” as the infrastructure relied on by theunionized workers for union deductions is harmed. (Photo:Shutterstock.com)

Connecticut has joined a new multistate lawsuit aiming to stop implementation of a new Trumpadministration rule that Connecticut and several other states saywould interfere with and in some ways undermine thousands of homecare workers who assist the elderly and disabled through Medicaidprograms.

The new “Final Rule,” issued by theDepartment of Health and Human Services on May 6, would effectivelyprevent long-established union deductions and benefit contributionsmade by Medicaid-based home care workers via direct payrolldeductions, according to the multistate suit, which was filedMonday in U.S. District Court for the Northern District ofCalifornia.

As a result, Connecticut and the otherstates argue, the unionized workers would be harmed and, in thewords of Connecticut, “undermined,” as the infrastructure relied onby the unionized workers for union deductions is harmed.

And as a result, both Connecticut andthe other states additionally contend, the vulnerable populationsthey serve may also suffer and lose out.

“The Trump Administration's final rulewould not only deny home care workers the right to fight for basicworkplace rights, but it would jeopardize the health and well-beingof the 15,000 Medicaid recipients who rely on this program forassistance,” said state Attorney General William Tong in anews release on Tuesday announcing that Connecticut had joined thesuit.

And the 36-page federal complaintstates at one point, “Finally, any changes to the States' Medicaidpersonal care services program that reduce the quality or stabilityof providers create real human costs for the beneficiaries of thoseprograms.”

It then adds that “individuals who areaged, blind and disabled and need assistance to perform activitiesof daily living are better served by consistent and well-trainedcaregivers.”

Both Tong in the news release and thecomplaint do concede that there would be one way around the effectsof the new rule, but say that it would not be tenable.

“While the States could, in theory,avoid risking this disruption by foregoing federal Medicaid fundingfor personal care services, doing so would forfeit more than $6.5billion in federal dollars, causing devastating harm to statehealthcare budgets and eroding the States' capacity to provideneeded homecare for seniors and persons with disabilities,” thecomplaint says.

The Department of Health and HumanServices on Wednesday declined to comment on themultistate lawsuit or Connecticut's role in it.

According to the suit, which is beingled by California but has been joined by Connecticut,Massachusetts, Oregon and Washington, “each of the States hassought to improve the quality and stability of Medicaid homecare byextending state laws that authorize public-sector bargaining to thehomecare workforce and permitting voluntary payroll deductionsand/or benefit contributions.”

More specifically, as Tong explainsabout Connecticut in his news release, the state in 2012enacted legislation creating the Personal Care Attendants WorkforceCouncil, and it gave home personal care attendants the right toform labor organizations for collective bargaining with thestate.

Moreover, Tong said, the majority ofstate home personal care attendants have joined the union and paytheir dues through payroll deductions.

“Connecticut law specifically providesfor deductions of union dues from the wages of personal careattendants pursuant to collective bargaining agreements, by afiscal intermediary of the state,” he added.

But the new final rule from the healthand human services department, he said, “interferes with thestate's ability to deduct payments for worker benefits obtainedthrough collective bargaining, like healthcare coverage orvoluntary union dues, from homecare workers' paychecks.”

“This rule would disruptwell-established collective bargaining relationships authorized fordecades by state labor laws,” Tong added.

The broader federal complaint,meanwhile, which seeks injunctive relief and a declaration that thenew final rule is unconstitutional, argues that “if implemented inaccordance with the Secretary's reinterpretation of the MedicaidAct, the Final Rule would undermine laws and agreements that haveimproved the provision of homecare to the States' residents,” and“it would disrupt well-established collective bargainingrelationships and weaken an organized workforce infrastructure thatthe States have.”

“Historically, homecare workers haveengaged in difficult, often physically-demanding work and faced lowwages, few benefits, frequent injuries, and unpredictable hours,with no means to collectively address working conditions,” thecomplaint also points out, adding that “since States' authorizationof collective bargaining, homecare workers have collectively chosenunion representation.”

Then, in arguing against the Trumpadministration's rule implementation, the states say in thecomplaint that the “Final Rule … purports to reinterpret theMedicaid Act in a manner that would prohibit States from directlywithholding these ordinary, voluntary deductions from homecareworkers' paychecks.”

They then add that “defendants'purported basis for this rule change is a 47-year-old provision ofthe federal Medicaid Act, 42 U.S.C. Section 1396a(a)(32) …that prohibits assignment of rights to collect payment for Medicaidservices to third parties,” but “Congress enacted that provision toprohibit a fraudulent medical financing scheme that bears norelationship whatsoever to legal payroll deductions such as uniondues or other worker benefits.”

The suit names the Health andHuman Services Department and its secretary, Alex M. Azar II, asdefendants.

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