For years now, rapidly growing taxpayer expenditures on Medicaid — a federal program established in 1965 and first sold to Americans as a health care benefit exclusively for low-income families with small children and individuals who are physically unable to work — have been major contributors to the spiraling cost of Big Government and the breathtaking expansion of the national debt. Federal taxpayers now fork over more than $600 billion annually to the program.

Recently, New York has emerged as a poster child for profligate Medicaid expansion. Thanks to the state’s pro-Big Government politicians loosening the program’s standards, New York’s Medicaid-funded Consumer Directed Personal Assistance Program (CDPAP), a program meant to help seniors seeking home care, tripled in size between 2019 and 2024.

This growth is not sustainable — nor is it legitimate. New York’s governor, Kathy Hochul — by no means a limited government advocate — has herself decried manipulation of CDPAP, telling Bloomberg that people were using it to draw taxpayer-funded salaries by “sitting home with [their] Grandma” and that it had become “one of the most abused programs in the entire history of the state of New York.”

By 2024, as a consequence of the rapid-fire expansion of New York’s CDPAP program, an estimated 12% of all private-sector jobs in the Big Apple were held by home health care providers.

So who stands to benefit from abusing Medicaid in this way, and what can be done to stop the abuse? The answers to both questions lie in the fact that union bosses of the Service Employees International Union (SEIU) 1199, NYC’s largest health care union and a potent political force, have a government privilege that allows them to skim “dues payments” from the payouts of CDPAP recipients (without any positive consent from them) as well as health care workers under the union’s bargaining control across New York City.

For SEIU bosses, then, expansion of CDPAP, even to people who are abusing the system, means more taxpayer money in their coffers. No one understands this principle better than President George Gresham of New York’s massive SEIU 1199 — who was a key player in multiplying both the total number of Medicaid enrollees and the total cost to state and federal taxpayers per enrollee.

It may come as a surprise to few that Gresham was the target of multiple different investigations into charges he had used Medicaid-fueled union funds for his own personal and political gain. An investigative report published by Politico last month showed that Gresham routinely spent dues-derived union treasury money to “benefit himself, his family, and his allies.”

Some of the expenditures that the investigation uncovered included hundreds of thousands of dollars spent to give singer Harry Belafonte’s nonprofit a penthouse office, hundreds of thousands more on a “get out the vote” R&B concert in rural Virginia, and paying do-nothing employees, just to name a few.

SEIU members ousted Gresham this month as bad press started to roll in concerning his malfeasance. But Gresham’s ouster only treats a symptom of Medicaid corruption and bloat, which is not limited to just New York.

Ideally, those abusing Medicaid programs like CDPAP under the auspices of union bosses will be barred from using them. But home care providers who legitimately use the system have a tool in their belt to stop “dues payments” from being skimmed off their payouts simply to enrich union officials like Gresham who will only further degrade Medicaid programs.

Under National Right to Work Legal Defense Foundation attorneys’ 2014 U.S. Supreme Court victory in Harris vs. Quinn, it is now illegal for states to force home care providers to join or bankroll a union as a condition of receiving Medicaid money. Home care providers can invoke this right to stop union dues skimming.

But the president can simply end the legal privilege that union officials have manipulated for years to auto-deduct “dues money” from funds intended to go to home care providers. The Trump administration should immediately terminate the Biden-era Center for Medicare & Medicaid Services rule that gives ethically-challenged union bosses like George Gresham the privilege to have union fees extracted straight out of Medicaid payments, before the money even reaches patients or their providers.

Mix is president of the National Right to Work Committee and the National Right to Work Legal Defense Foundation.

https://www.nydailynews.com/2025/05/22/trump-must-stop-union-medicaid-abuse/