Health Care Case Could Change Labor Union Landscape

An Illinois nonunion private healthcare workers’ case, recently heard by the Supreme Court, is putting a magnifying glass to the way such workers operate, and could change the way labor unions operate both within and outside of the home health sector.

In the Harris v. Quinn case, nonunion private home care workers charge their First Amendment rights have been violated because they have been required to pay fees to a union that bargains on their behalf for Medicaid payment.

The National Right to Work Committee Legal Defense Foundation, representing the plaintiffs, is arguing that all public sector bargaining is political, because it deals with state budgets, Healthcare Finance News reports.


“Therefore, if these groups are political, no workers should be forced to pay money into their coffers,” Healthcare Finance News says.

It’s important to note that private home health care is an industry unlike many others, Dorie Seavey, senior policy advisor at PHI National, tells Healthcare Finance News.

When families need services that will be paid by Medicaid or other public funds the family must recruit the worker on their own, rather than contracting with an agency, Seavey says, noting that the private worker is then paid directly through the state.


There are about 800,000 independent home health workers receiving public funds — the fastest growing part of home health care, Seavey says.

Infrastructure is lacking at the home health level, Seavey says, adding the states that allow collective bargaining have seen improvements, such as higher wages, benefit programs, paid vacation and more.

States like Illinois say issues like lack of infrastructure is why they have forced nonunion home health workers to pay into the system, Mark Neuberger, an attorney at the law firm Foley & Lardner LLP, tells Healthcare Finance News.

“If you want to organize at a General Motors factory, you group everyone under the roof,” Neuberger says, adding that home health care doesn’t work that way.

It’s possible the court’s ruling won’t just affect private home care workers in Illinois, but could have a wide-reaching affect on organized labor, industry leaders say.

“If the court were to rule that they couldn’t force workers to pay into the system, it would dramatically reduce both revenue and bargaining power for unions,” Bill Dombi, president of the National Association for Home Care & Hospice, tells Healthcare Finance News. “It could impact other groups’ nonunion workers at state and county offices as well.”

Read the full article here.

Written by Cassandra Dowell