Attorney General Becerra Files Lawsuit Defending California’s Medicaid In-Home Supportive Services Workers

Monday, May 13, 2019
Contact: (916) 210-6000,

SACRAMENTO — California Attorney General Xavier Becerra today led a multistate lawsuit opposing the Trump Administration’s final rule that undermines more than half a million workers in California’s In-Home Supportive Services (IHSS) Medicaid program, and several hundred thousand more workers nationwide. In California, these workers have the right to collectively bargain for better wages, benefits, and training, which results in a more stable, quality IHSS program for beneficiaries. The new federal rule creates barriers for states to deduct employee benefits and union dues from workers’ paychecks. By doing so, it makes it harder for workers to stand up together for their workplace rights and to provide quality home and community-based care to those in need. It puts at risk the more than 594,000 seniors and people with disabilities who receive assistance from the IHSS program.

“With this rule, the Trump Administration is not only harming Medicaid skilled homecare workers who have joined unions, but the millions of seniors and people with disabilities who depend on these indispensable workers,” said Attorney General Becerra. “This rule jeopardizes the health of vulnerable Californians who are currently able to live at home thanks to Medi-Cal’s IHSS program. The California Department of Justice will continue to fight to protect our workers and the families they serve.” 

On July 10, 2018, the U.S. Department of Health and Human Services released a proposed rule to reinterpret Medicaid state payment requirements. The rule was primarily based on a supposed need to “eliminate a state’s ability to divert Medicaid payments away from providers.” Yet, the federal government provided no evidence to suggest that Medicaid payments were being inappropriately diverted. Under California law, Medicaid in-home workers who are hired by seniors and individuals with disabilities to provide personal care services, such as bathing, feeding, dressing, and transportation, are authorized to collectively bargain. The federal rule interferes with States’ ability to deduct payments for worker benefits obtained through collective bargaining, like healthcare coverage or voluntary union dues, from homecare workers’ paychecks. This rule would disrupt well-established collective bargaining relationships authorized for decades by state labor laws.

On August 13, 2018, Attorney General Becerra sent a letter to Health and Human Services Secretary Alex Azar opposing the proposed rule. Despite opposition from states charged with administering the Medicaid program and no hard data to support the need for such a rule, the Trump Administration acted to finalize this rule on May 6, 2019. While the States could, in theory, avoid disruption to their state labor arrangements by foregoing federal Medicaid funding for personal care services, doing so would forfeit more than $6.5 billion in federal dollars, causing devastating harm to state healthcare budgets and eroding the states’ capacity to provide needed home care for seniors and persons with disabilities.  

Joining Attorney General Becerra in filing the lawsuit are the Attorneys General of Connecticut, Massachusetts, Oregon, and Washington. 

A copy of the complaint is available here

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