The U.S. Women’s Soccer Team Is Fighting for Better Pay — and the Rest of Women’s Sports Depends On It

When it comes to iconic U.S. soccer teams, none tops the 1999 U.S. Women’s National Team. That squad is still so special today because its tournament run, culminating in a shootout victory over China before a huge crowd in Pasadena’s Rose Bowl, created a wave of change that led to more funding and resources for the women’s national team, as well as the founding of the first North American women’s soccer league.

When asked about the ‘99ers, as they’re known, at U.S. Soccer media day last month, forward Alex Morgan simply replied: “Now it’s our turn to make our mark.”

Indeed, twenty years after the 1999 tournament, the U.S. Women’s National Team is again seeking both a World Cup title and a massive shift in the perception of a woman’s worth in sports. Moreover, women athletes in other sports are hoping Team USA’s success will mean more power for them in their own labor organizing efforts.

In March, U.S. players filed a class action lawsuit against the United States Soccer Federation (USSF) for gender-based discrimination. The lawsuit highlights inequities in travel conditions, promotion of games, staffing, and support and development. All are persistent despite improvements that came with a 2017 collective bargaining agreement and after a 2016 lawsuit.

The latest lawsuit states that the U.S. women were offered $40,000 less for making the 2015 World Cup roster than men were offered for making a 2014 roster. That pay gap stretched to $53,750 by 2018. The lawsuit also states that the women’s team made 38 percent of the compensation of the men’s team from March 19, 2013 to December 31, 2016, despite bringing in more revenue than the men’s team in 2016.

The revenue surplus on the women’s side is impressive, but does represent an outlier, and is greatly driven by the 2015 World Cup and subsequent victory tour. Knowing that, players were willing to have compensation increase only in years they outearned the men’s team.

U.S. Soccer denied these claims in their defendant’s answers and affirmative defenses filed May 6, 2019, stating “the current CBA provides for player compensation that increases based on increased viewership, attendance and sponsorship revenue, in each case over and above their guaranteed salary and other benefits.” So 28 players, including 22 on the 2019 World Cup roster, are moving forward with their lawsuit.

When comparing the list of accomplishments for the women’s national team, which includes three World Cup titles, four Olympic gold medals, and being ranked number one in the world for 10 of the last 11 years, to that the men’s national team, which has no World Cup titles or Olympic medals and hasn’t even qualified for the Olympics since 1988, one can hardly say the pay scale is based on merit.

Other female professional athletes see the soccer team’s argument as air-tight. They also believe a win in court for the U.S. team will mean a win for them too.

“When you look at the women’s national soccer team, they are better than the men, they do generate more money, they do pack the stands,” said four-year WNBA veteran Imani McGee Stafford, a center for the Dallas Wings. “They check all of those boxes and the only conversation as to why they don’t get paid like the men is because they are women.”

WNBA players recently opted out of their collective bargaining agreement and hope to negotiate with the NBA for better travel regulations, higher salaries, and higher revenue splits. Sports economist David Berri noted the current agreement with the WNBA and the NBA, its overseer, offers players roughly 25 percent of WNBA revenue, while NBA players own a 50 percent split of revenue. Additionally, NBA player contracts protect players from playing within 24 hours of travel between time zones. WNBA contracts do not.

If the women’s soccer team is the standard for WNBA players, the 23-year-old women’s pro basketball league is the standard women’s hockey players hope to achieve, as professional women’s hockey has struggled for years to stay afloat. In the 2017 #BeBoldForChange boycott and the current #ForTheGame movement pushing for what they deem a viable league, women’s hockey players seek a North American league that can pay a livable wage and meet professional standards.

Women’s hockey players recently organized the Professional Women’s Hockey Players Association, which consists of more than 200 hockey players, including all of Team Canada and Team USA, who say they will not sign contracts to play in North America. The #ForTheGame movement made waves on social media on May 2, one day after the closure of the Canadian Women’s Hockey League (CWHL), which left the National Women’s Hockey League (NWHL) as the only professional league left standing in North America.

“We are fortunate to be ambassadors of this beautiful game, and it is our responsibility to make sure the next generation of players have more opportunities than we had,” said USA Hockey forward and 2018 Olympic gold medalist Kendall Coyne Schofield in the PWHPA release. “It’s time to stand together and work to create a viable league that will allow us to enjoy the benefits of our hard work.” Coyne Schofield earned $7,000 playing for the 2019 NWHL champion Minnesota Whitecaps. Canadian 2018 silver medalist Sarah Nurse earned $2,000 playing for the Toronto Furies in the CWHL.

But is the fact that other women athletes are watching the women’s soccer team’s fight so closely added pressure or motivation?

“I think it’s both,” said midfielder Morgan Brian. “Seeing those other women’s professional teams follow along with our journey, I think it inspired us to continue to keep the conversation going and to push for more … that’s something that we’ve always had in our DNA and want to be a part of us. We’re not only great on the field and pushing along the women’s game, but we’re also pushing along the women in this world.”

I have not been financially rewarded for what I’ve given and the success I’ve reached.
– Ashlyn Harris

Goalkeeper Ashlyn Harris said that because she is preparing for a World Cup, she has a platform to speak about equality and a duty to use it, especially as she looks towards the end of her career.

“I’ve dedicated my entire life to my craft,” said Harris. “I have not been financially rewarded for what I’ve given and the success I’ve reached. So why do we speak up? Because I don’t want the future to have to worry about what I have to worry about in a few years, and that’s starting this life all over again at 35.”

After the World Cup, Harris and her World Cup teammates will continue their fight with U.S. Soccer. It is important to note that, while the 2019 lawsuit specifically seeks damages for national team players, the team still knows there is work to do in the USSF-owned National Women’s Soccer League.

Since 2016, the national team has found ways to incorporate the NWSL into its fight for gender equality in soccer, as players in that league who don’t play for their respective national teams don’t make a livable wage, and some NWSL teams even lack proper training conditions.

Crystal Dunn, who will be playing in her first World Cup, returned to the NWSL after being one of the final cuts from the 2015 World Cup roster. “World Cup years, I think are incredible. What [playing in NWSL] did for me was it allowed me to regroup and reset,” said Dunn. “That’s basically what really was important for me in 2015, was having the league to be able to take my mind off over everything else.”

The NWSL did raise the overall salary cap per team to $421,500 for the 2019 season. The increased salary cap brings the league minimum salary to $16,538 and the league max salary to $46,200, according to a January league release. The league also increased the housing allowance for each franchise, perhaps in light of controversy endured by New Jersey last year. Sky Blue FC came under massive heat when players began talking about the subpar conditions they faced for years. Training facilities with no running water, no showers at their home field facilities, and deplorable housing were just a few things they brought to light.

For all of these reasons and more, the fight off the pitch is important to the women’s national team. So too is playing to up their standards in France. The goal: World Cup champion or bust.



A 20 Cent Raise Can Cause Iowans to Lose Thousands of Dollars in Child Care Support

Getting a raise is nearly always a good thing, but for working families in Iowa, earning 20 cents more per hour can mean losing thousands of dollars in child care assistance.

Families below the poverty line in Iowa are eligible to receive support for the majority of their child care, a benefit that can be worth more than $11,000 per year. Families are still eligible for the most of the credit — about $8,000 per year — until their incomes reach 145 percent of the poverty line, or about $25,000 for a single parent with one child. But if that parent’s income is just one percentage point higher, they aren’t eligible for support at all.

That steep and dramatic cut-off point for assistance is combined with one of the lowest income thresholds in the country; neighboring states such as Kansas and Minnesota both set their cut-offs above 180 percent of the poverty line.

These programs are paid for by the Child Care and Development Block Grant (CCDBG), which has provided money to all U.S. states and territories for the purpose of helping low-income working parents afford child care since 1990. However, the program was chronically underfunded for decades, and by 2015 served the fewest children in the program’s history. In 2018, Congress increased discretionary CCDBG funding by about 80 percent for fiscal years 2018 and 2019, to help make up for some of the shortage. While this money was intended to make sure more children would receive care, Iowa’s eligibility ceiling has remained capped at 145 percent, where it has been for more than 10 years.

The 2018 increase in CCDBG funding means Iowa has $13 million more from the federal government to spend on child care assistance. While the Iowa legislature appropriated $3 million of the new CCDBG funding to increase reimbursement rates for child care providers, the rest of the funding increase hasn’t yet been allocated by Iowa’s legislature. At least 70 percent of the increase must be spent on direct services like expanding the number of families eligible for child care assistance or improving the quality and safety of child care in the state.

At the Iowa minimum wage, which remains frozen at the federal level of $7.25, pulling together the $186 per week it costs on average to pay for child care for one child takes 26 hours of the wages in a 40-hour week. Nearly two in every three Iowan parents working full-time would have to spend more than seven percent of their income to afford a child care center, exceeding the federal benchmark for affordability.

When getting a 20 cent raise means losing nearly the full value of the child care assistance benefit, the pressures on families are so strong that some working parents in Iowa are turning down small pay raises offered by employers to keep their Child Care Assistance (CCA) eligibility. In December of 2018, the federal Office on Child Care issued a citation to Iowa indicating the state wasn’t allowed to terminate benefits if the family initially qualified for CCA and saw only a modest increase in income. While Iowa is required to make this fix, the change is unlikely to help families who hover just above the threshold for eligibility.

Dave Stone, advocacy officer for United Way of Central Iowa, sees cost as the main sticking point for Iowa legislators hesitant to expand eligibility and soften the cliff effect. “Child care is expensive,” says Stone, and Iowa has “not been keeping up the appropriations” as child care costs have risen faster than wages.

The Beasleys are some of the people struggling to get by just above the cut-off for assistance. Katherine Beasley, her husband Dan, and their two kids, Peter (seven) and Noah (one), live in the Oakridge Neighborhood of Des Moines, a community that provides additional services to support their residents. When Noah was born in 2018, Katherine lost her job — in the first few weeks after Noah was born, he was frequently sick, and Katherine’s employer wasn’t happy that she wasn’t working enough hours. With only her husband Dan’s income, the Beasleys quickly drained their savings and fell behind on bills. By the time Katherine got a new job, her family had received their last possible extension from their utility company, and were about to have their electricity shut off. With her first paycheck, her family was just above the cutoff point for assistance.

“It was very stressful. You try not to show it to the kids, but you do feel depressed,” said Katherine. “The most important part was making sure the boys would be fed; sometimes there wasn’t anything left for us after feeding the boys.”

Through Oakridge, Katherine was able to access a program funded primarily by corporate donors that pays all but $50 of Noah’s $220 weekly child care cost. Even still, when Peter finishes elementary school for the summer in a few weeks, she doesn’t know how she’ll find care for him and still make ends meet if her next request for State Pay isn’t approved.

“I was taught that financial problems stay at home, so nobody really knows. I’d been raised not to ask for help, but it comes down to putting your kids first and supporting them,” she said. Struggling to provide for young children can be a stigmatizing experience. Perhaps this is why political interest in child care affordability lags behind higher education, despite the fact that child care is more expensive than college tuition in 28 states.

You try not to show it to the kids, but you do feel depressed.
– Katherine Beasley

Without the Oakridge Neighborhood child care assistance, Katherine said she wouldn’t be able to continue her progress towards a nursing degree, a move she hopes will permanently change her family’s financial trajectory. “I’d have to get two jobs. The kids would never have mom or dad at home,” Katherine said, adding that it’s important to her that she has enough time to advocate for the needs of her older son, a special education student.

Helping families like the Beasleys is one reason why United Way of Central Iowa, along with their Skills2Compete Coalition partners including the Iowa Federation of Labor, AFL-CIO, and the Iowa State Education Association, have called on the Iowa state legislature to expand eligibility for CCA to at least 185 percent of the federal poverty line. The United Way of Central Iowa’s proposal would phase out assistance gradually using copays. To Stone, getting rid of the steep “cliff effect” is key. With a gradual phase out, families wouldn’t need to refuse small raises or avoid getting higher-paying jobs to maintain crucial child care assistance.

United Way of Central Iowa estimates implementing its proposal would cost around $22 million per year. On a federal level, the Child Care for Working Families Act, which is co-sponsored by the majority of congressional Democrats, would provide free child care to all families earning less than 75 percent of their state’s median income and cap spending for families earning up to 150 percent of the federal poverty line at 7 percent of their income. Sen. Elizabeth Warren (D-MA) has also proposed her own plan to pay for child care for all families making less than 200 percent of the federal poverty line, and to provide support for families earning more than 200 percent of the federal poverty line who still can’t find child care at less than 7 percent of their income..

“We know support for children is critically important for adults to have success — in work, in certification programs, or in education. And we need to make sure that children get the support they need to enter kindergarten on par with their peers,” said Teree Caldwell-Johnson, CEO of Oakridge Neighborhood Services. If Iowa appropriates enough money for affordable child care, a generation of parents will have the freedom to make a better life for their families, and a generation of children will start their lives on more solid footing.

Editor’s note: The Beasley family requested that their name be changed for privacy.

You try not to show it to the kids, but you do feel depressed.
– Katherine Beasley


First Person

Dental Care Was a Path to Opportunity. Then I Couldn’t Afford It Anymore.

I spent every morning as a child in the bathroom, brushing my teeth — stained yellow as if they had been dipped in melted butter — as hard as I could. My grandmother blamed the fluoride in the water that we drank. I didn’t know if she was telling the truth or not; in the end I was still ashamed of my smile. My classmates would gleefully shout “Butterteeth” whenever I crossed their paths, and the boys called me ugly. When I talked to other students, they would stare at my mouth and remark that I had something on my teeth. My face would turn hot and red, my sentence trailing off as they made a brushing motion; after realizing their mistake, they too would grow quiet and the air would be filled with shame.

I lived with that smile for 16 years. My family constantly struggled to stay afloat, and even though my single mother worked a full-time job, she couldn’t always afford health care. We went to the doctor when we were sick, not for checkups. Sometimes important issues got pushed to the back burner to make room for the day-to-day necessities, and one of those issues was dental hygiene. The appearance of my teeth felt like a declaration of my family’s lack of wealth. There are photos of me smiling brightly throughout that time, though, because even though a sense of shame followed me, I tried not to allow myself to be defined by what I looked like.

When I turned 17, my best friend’s mother started bringing me to and from the dentist’s office, a place that I hadn’t visited in almost a decade, though I don’t know how those trips came to fruition. The topic of health insurance was never brought up, and my friend’s mother never mentioned having to pay a cent. It was suddenly available to me, and I didn’t bother to ask any questions. All I knew was that I was being helped and I was so grateful. I didn’t realize just how much pain the years of neglect would cause me, though.

My mouth would fill up with blood at any opportunity, to the point where my dentist would whisper to his assistant that he wasn’t sure if he would be able to continue with that day’s work. Even a basic routine cleaning would cause my hands to shake, and soon the assistant would be packing my mouth with cotton balls in an attempt to soak up the blood. The assistant would change with every session, but the dentist and I developed a routine because he never changed. He was a kind man, always asking how my classes were and if I needed more procaine. I’d shake my head or make a noise to answer, and then he would stare back into my mouth while tears ran down the side of my face.

On the worst days, the room filled with the smell of my teeth being filed down to make room for silver caps. One evening, as I was coming home from the dentist, I coughed up blood onto a bus seat as it was pulling up to my stop. I confessed to the driver and quickly ran out the door. At home I would eat soft food, wincing when cold hit the caps, freezing them for a moment. They weren’t joking when they said beauty was pain, but “it will all be worth it,” I told myself, massaging my sore jaws.

When I listened to the voicemail from my dentist telling me my insurance was covering the cost of five porcelain veneers, I smiled to myself as I cried on the school bus. I replayed that message over and over, and the next time I climbed into the dentist’s chair, I did it with pride. It still hurt, don’t get me wrong, but when he handed me the mirror and I saw myself with my new teeth, I burst out in tears. The sounds of those children taunting me were gone; I was one of the lucky ones.

Then I grew up.

As I grew older, I fell into the same trap as my mother. Cleanings became few and far between because I was working two jobs and the dentist’s office closed too early. When I was 22, the veneer placed on my right tooth fell off in the middle of the night and I swallowed it in my sleep. That morning, I had to rush to the emergency dental clinic on my one day off. The location closest to me was a short bus ride away, and I managed to keep my mouth shut tight the entire ride there, nodding “yes” or “no” in response to questions that were thrown in my direction by the bus driver or other friendly riders.

My dental plan consists of aspirin and liquid numbing medicine.

The office receptionist told me the procedure would cost me around $2,000, and when I told them I didn’t have anywhere near that amount in my bank account, they told me to sign up for the credit card the practice offered and start a payment plan. I sat in the chair, filling out my personal information, and was approved for an even $1,000. I sobbed as I walked down to the bank, punching my PIN into the ATM to get some cash for my first payment. I got a new temporary crown, and while I knew it was important and I desperately needed it, I asked myself if the cost was worth it.

I still believe that it was. I knew that if I went backward, if I came anywhere close to having my former smile, I would be screwed. I hadn’t been able to get a job with my old grin because the boss would spend the whole interview watching my mouth move, but after my teeth were fixed, the job offers came closer and closer together. I hadn’t been able to date comfortably beforeand now, with the gift of new teeth, I was suddenly lucky and in love. These teeth had saved me from a life that I was too afraid to think about.

It has been almost five years since I last went to the dentist. Every morning I wake up and press the tip of my tongue along the backs of my front teeth, hoping I haven’t swallowed another one in the middle of the night. I brush my teeth, ignoring the way the toothpaste turns a brownish-red color, and head off to work, where I work close to 50 hours a week between two jobs. Because I can’t afford to leave one and work full-time at the other, I don’t have health insurance, much less dental insurance. My dental plan consists of aspirin and liquid numbing medicine. It runs me an average of $12 every couple of months. I didn’t even know the pain in my tooth could be connected to the pain in my ear until I googled it. (That’s another thing that people don’t tell you about being poor: Google and WebMD are part of your health care plan.)

Now when people stare directly at my teeth, they are noticing how white the front row is. They remark that my teeth are perfect and want to know my secrets: Is it a special toothpaste? Mouthwash? Did I just get lucky? I always joke and tell them that they better be perfect because they cost me a lot, physically and emotionally.

The dentist still scares me, and I don’t know when I will be able to schedule another visit. I hope that one day, I’ll scrape together the money to have my wisdom teeth taken out. Better yet, I hope that one day, I’ll be able to work one single full-time job, a job that will offer me benefits including dental. I hope that one day, I’ll be able to have my teeth cleaned every six months instead of once every decade.

It occasionally hits me that even after all this, I’m still one of the lucky ones. People still think that I’m beautiful, and that’s enough to get me through this life. All I can really do is keep smiling.



Inside the Fight Over the Last Hospital in D.C.’s Poorest Neighborhood

Arnel Jean-Pierre has been a nurse at Washington, D.C.’s United Medical Center for seven years, and he’s seen a lot. If the D.C. city council has its way, though, the hospital will shut its doors for good in the coming years. According to Jean-Pierre, that’s going to cause a lot of avoidable pain for the residents of D.C.’s poorest neighborhoods.

“The end result is a lot of people are going to suffer,” he said.

D.C.’s council recently gave preliminary approval to a plan that would close United Medical Center, known as UMC, in January 2023, while reducing the city’s financial contributions to the capital’s only public hospital in the intervening years. Hospital officials say they need some $40 million to keep operating in this fiscal year alone, but the city’s payments going forward would be capped at $15 million annually.

The move — which will be up for a final vote on Tuesday — has activists and workers at the hospital concerned, for a whole host of reasons. It also fits into a wider recent trend of hospitals closing up shop in the neighborhoods that can least afford it.

UMC is currently the only hospital in Washington that is not in the city’s northwest quadrant — which is both its whitest and richest. The city is grappling with the effects of widespread gentrification and rapidly changing demographics. By one measure, it is the fastest gentrifying city in the country, and in the top four for most black residents displaced. The population UMC serves is majority black, the poorest in the city, and disproportionately composed of Medicaid and Medicare patients.

If the budget cap is implemented, UMC will have to cut back services before ultimately closing. Already, UMC has reduced services due to budget constraints and financial woes, including closing its cancer clinic; a notice that the hospital will lay off employees within the next 60 days was circulated recently. Meanwhile, a proposal to open a new private hospital in that part of the city is far from a done deal, meaning the current hospital has an explicit end date, but the plan for replacing it is only half-baked.

“There is a closing date in the legislation that is not tied to the opening of any other hospital and right now, the city is still only in negotiations with the new Ward 8 hospital provider, which seems to have many roadblocks. So we don’t know what a realistic timeline is to have a new hospital in that part of the city,” said Elizabeth Falcon, executive director of D.C. Jobs With Justice, which is fighting the budget cuts.

Cutting back at UMC will mean longer wait times for its patients, and according to Jean-Pierre, higher mortality rates for those who suffer from strokes, heart attacks, and gunshots, as they are the most vulnerable when delays occur.

“There’s a lot of delays now, but to even cut more is going to create a catastrophic event,” he said. “They’re paying taxes just like the folks in Georgetown, [the richest part of D.C.]. Why should they have the delay in health care when they face a stroke?” For some residents in the area, the next nearest hospital after UMC is a nearly nine-mile drive away, which can take more than an hour in rush hour traffic. And the hospitals closest to UMC already say they have more patients than they can handle.

“Too many of our debates in DC are win-lose or lose-lose. UMC is another example. The debate shouldn’t be: New hospital in Ward 8 or responsible patient care at old hospital in Ward 8. It needs to be both. Vulnerable lives are at risk,” tweeted D.C. council member Elissa Silverman.

But the closing of UMC is about more than just one hospital in one part of one city. It is also emblematic of larger trends in which hospitals are closing, consolidating, and moving out of low-income urban neighborhoods in favor of neighborhoods with richer residents.

In 2014, a Pittsburgh Post-Gazette/Milwaukee Journal Sentinel analysis found that the number of hospitals in major U.S. cities fell by nearly half between 1970 and 2010, and most of those that closed were public hospitals or hospitals located in low-income neighborhoods. Meanwhile, two-thirds of hospital openings during the same time period were in more affluent neighborhoods.

D.C.'s poorest residents are saddled with its least-functional hospital.

That tracks with D.C.’s experience. The city lost Providence Hospital, in its northeast quadrant, earlier this year, and now UMC has been put on life support, while its four other major hospitals are in wealthier or rapidly gentrifying parts of the northwest.

Not surprisingly, hospital closures lead to worse health outcomes, particularly for those who suffer from heart attacks or injuries that require immediate medical attention. Areas that lose hospitals also tend to lose other medical services as well, as doctors and other practitioners move away or decide to open new practices elsewhere. This turns low-income areas into health care deserts.

Plus, those same areas tend to be the least served by public transit, and have the most residents who don’t own their own modes of transportation, putting ever-higher barriers between patients and the care they need.

“Localities are getting out of the business of running hospitals. That doesn’t mean people are out of the business of getting sick in every neighborhood,” said Falcon. “We are at a moment in history where governments don’t like paying for government services.” Available data on hospital closures is not great, but between 1996 and 2002, per one study, at least 13 public hospitals closed; another study found that public hospitals that closed between 1990 and 2010 were in neighborhoods with significantly higher percentages of black residents than public hospitals that remained open.

On the private side, meanwhile, powerful, multi-facility health systems are responsible for much of the hospital consolidation cities have experienced. Between 2005 and 2017, there were 1,000 hospital merger and acquisition deals announced. 40 percent of hospital stays now occur in markets in which there is only one hospital owner. Such consolidation, in addition to making hospitals fewer and farther between, drives up prices and drives down management quality.

UMC has had its struggles, of course. A slew of errors led regulators to shut down its obstetrics ward in 2017. The only reason the city has been running the hospital at all is that its financial misadventures necessitated a 2010 rescue from bankruptcy. But few think that the city would let it collapse completely. Organizers are moderately confident that, if a new hospital is not completed in the neighborhood by January 2023, the council would at least continue to keep UMC’s emergency room open.

But none of that stops the slow bleeding already occurring there, or makes up for the preventable illnesses, injuries, and deaths that will happen in the intervening years due to the cap on funding; it says nothing good about the city that its poorest residents are saddled with its least-functional hospital. None of UMC’s problems change the fundamental fact that the bulk of D.C.’s available health care services are in the parts of the city where the residents are the wealthiest.

“We are trained to do no harm,” said Jean-Pierre, the UMC nurse. “But the D.C. council does not live by the same code of ethics. Based on the cutting, they’re doing a lot of harm.”



Trump’s New Union-Busting Rule Will Wallop Home Health Workers

Earlier this month, the Department of Health and Human Services finalized an obscure rule that could have huge implications for an estimated 800,000 independent home health providers paid directly by the state for Medicaid-funded services. Under the rule, these workers will no longer be able to assign deductions from their paychecks to cover things like insurance premiums, retirement contributions, and union dues. The rule singles out the most isolated home health workers who are not employed or paid via agencies; those who are can assign deductions at will.

Advocates argue the rule is designed to suppress unions by making it more difficult to collect dues. And there’s more than union dues at stake: Home care providers could, for example, experience lapses in health coverage by failing to keep up with premiums.

Many home care workers are family members providing home and community-based care to loved ones. Their work can include assistance with activities of daily living like bathing, dressing, and toileting, along with light housekeeping, help with errands, and other services designed to help disabled people and older adults stay in their communities. Home care is one of the fastest growing professions in the United States, with a projected growth rate of 41 percent for those working at agencies.

The median wage for home care workers is $10.49; a 2017 National Employment Law Project survey found unionized employees made $2 more per hour when examining the difference between weighted average wages. The majority are women of color, reflecting the gendered and racialized history of the field, and 28 percent are themselves on Medicaid.

In some ways, Medicaid-funded home care can act as an anti-poverty program and compensate people for care work that is normally considered unworthy of pay. “When I found out about In-Home Support Services [the California implementation of the program],” said Andrea Dudley, who cares for her son, “it was like a godsend…it’s not a lot of money, but it’s helped me.”

It was like a godsend…it’s not a lot of money, but it’s helped me.

Home health work, like other labor that takes place in the intimate setting of the home, has been historically undervalued. When the Fair Labor Standards Act (FLSA) passed in 1938, domestic workers were explicitly excluded from wage and hour protections, in part at the behest of Southern Democrats. In the years since, domestic workers, including those offering home health services, have fought to organize. In the 1970s, Congress amended the FLSA to cover some domestic workers, but home health aides were still left out by a provision excluding “babysitters” and “companionship services.” But recently, they’ve started making gains. They won wage and overtime protections under FLSA in 2015 and have grown home care worker union participation. In 2010 they pushed for the passage of a Domestic Worker Bill of Rights in New York, and a similar national bill to extend these protections nationwide has been introduced by Sen. Kamala Harris (D-CA) and Rep. Pramila Jayapal (D-WA).

Now anti-union proponents, pushed by groups such as the National Right to Work Committee, are on the offensive. In 2014, they won a significant victory with Harris v. Quinn, which ruled that home health care workers are not public sector employees. Therefore, those who choose not to join the union may not be required to pay service fees, enjoying the benefits of collective bargaining without the costs.

In this instance, the government argues Medicaid monies should only be paid out to providers, with exceptions for tax deductions but not for third-party payees. In response to concerned comments about the implications of this rule, the government insisted that “it in no way prevents” home health workers from paying union dues, insurance premiums, and other costs via other means. To prove their point, HHS staffers even calculated the cost of envelopes and stamps for mailing payments.

While HHS staffers dismissed concerns, worker advocates argue this rule change could make things extremely difficult for home health workers, and not just when it comes to sending in union dues. Some are unbanked, making it challenging to mail a check. Others deal with significant demands on their time and schedules that could make it hard to keep track of due dates and mail things on time. Issues like these could potentially lead to lapses in health coverage and other problems that could be easily resolved with automatic deductions. More to the point, home health workers themselves have repeatedly stated they want the option to make assignments.

The extremely targeted nature of this rule has big implications. Independent providers are difficult to organize because of their far-flung nature. They don’t have a shared office, meeting place, or workspace to network, because they labor entirely in private homes, out of the public eye. They are underpaid and vulnerable to exploitation. Union membership can change that. Dudley commented that the union helps her “stay informed” and connected with other workers.

The rule is “a blatant attack on us,” she added, asking what should make care workers in particular subject to a bar on withholdings. It’s a question shared by other worker-advocates and their allies. Unions such as the SEIU and AFSCME are organizing against it, and at least five states are suing.

“It’s our choice to take our deductions out of our checks,” said Dudley.