As I understand this suit, what is involved is Illinois’ home- and community-based Medicaid waiver program. The standards for these programs are, like all other state Medicaid programs, laid out in fairly substantial detail by the federal regs. which the states must meet to receive federal funding or matching of funds. While Medicaid programs are nominally state programs, since they must meet the detailed federal standards, they aren’t like what one typically thinks of as state law. Accordingly, there wouldn’t be much, if any, bargaining at the state level.

So, who was actually doing the “free riding” is in question. It always sounded to me that SEIU, by getting its friends in the Illinois legislature to enact union membership as a requirement for the home and community based workers caring for this Medicaid program’s recipients, was the one doing the free riding (the state must meet the federal standards and make sure that the home and community based workers comply with those standards, while SEIU gets to collect union dues so the workers can qualify to provide services under the program).

“Will the Harris v Quinn decision affect other state homecare programs?
by caliguy”

“Tejinder — It certainly could: One of the key points of the Harris decision is that the customer (i.e., the patient) is the nominal employer of the home-carer. Thus, in any state where the program is structured that way, I would expect Harris to have some impact. The majority opinion begins by noting that millions of Americans across the nation use these programs, suggesting an intent to make policy quite broadly. At this time, though, I don’t know exactly how many programs that is.”