NY’s Boom In Home Health Aides Is Just Another Medicaid Racket

Not long ago, I wrote in The Federalist about “labor unions’ racket,” as it relates to corruption within one Service Employees International Union (SEIU) local. But the “racket” doesn’t end there. It extends to the people who finance it: federal taxpayers like you and me.

You don’t have to take my word for it. Consider the following quote:

I’m telling you right now, when you look on TikTok and you see ads of young people saying, “Guess what, you can make $37 an hour by sitting home with your Grandma. You know, here’s how you sign up,” it has become a racket.

The speaker is none other than New York’s Democrat Gov. Kathy Hochul, describing her own state’s Medicaid program. And the reason why she has suddenly changed her rhetoric and refuses to fix the problem has much to do with the union corruption I wrote about recently.

Union Dues Skimming

As with most things in politics, keen observers should follow the money. The New York Post recently criticized Hochul for reneging on her plan to attack the “racket” she described last year, with the Post alleging that she “switch[ed] sides with an eye on her re-election run” in 2026. 

The outlet explained that “the health care worker unions — above all, 1199[SEIU] — are a ginormous lobbying power.” The push to expand home health workers, including family members giving care, which Hochul previously criticized as a “racket,” has “morphed into a mass unionization drive,” as the Post noted.

Explosion of New Aides

That “mass unionization drive” comes as home health jobs within New York state have soared. The Empire Center, a conservative think tank, reviewed the data from the Bureau of Labor Statistics. From 2023 to 2024, home health employment grew by 57,000 jobs in New York alone. That’s a 10 percent increase in home health employment within one year, with New York accounting for one-fifth of all the new home health aides nationwide.

On both an absolute and relative basis, the data reveals New York’s absurdly high number of home health aides. The Empire State has more than three times as many home health aides (623,000) as fast food workers (183,810), and more than four times as many aides as waiters and waitresses (140,890). On a relative basis, New York has by far the most home health aides per 1,000 senior citizens, more than twice as many as the national average and 24 percent higher than the next-highest state, California.

As one observer told Newsweek last year, the home health aide program started with good intentions by “allow[ing] family members and friends to get paid for providing home health assistance to loved ones using Medicaid and Medicare dollars. The problem is now you have individuals taking advantage of a pretty liberal, open-ended process for determining who qualifies.” 

Taxpayer-Funded Union Largesse

The other problem is political: Because these sham aide “jobs” are a source of new members for unions like 1199SEIU — the aforementioned organization whose leader, George Gresham, has treated member dues like a personal slush fund — Democrat politicians have no desire to clean up the corruption. In other words, Hochul suddenly likes Medicaid fraud, so long as some of the proceeds of that fraud, in the form of dues paid by members of unions like 1199SEIU, end up financing her reelection.

Of course, that also means that Washington — meaning people like you and me — is funding fraud on multiple levels. First, federal taxpayers are directly financing Medicaid home health spending on aides engaging in sham jobs. Then, because many of those phony aides also pay dues to unions like 1199SEIU, taxpayers are also indirectly funding that union’s improper spending on things like Gresham’s trips to South Africa and lavish concerts coinciding with his family reunions.

Why Washington Needs to Act

This dynamic provides reason enough why, if Hochul won’t clean up the Medicaid “racket” in her state, then Congress and federal investigators should do it for her. While many home health aides do wonderful, labor-intensive work — they have cared for my mother for several years (albeit not using Medicaid funds) — that should not give anyone license to claim scarce taxpayer dollars for providing services to people who do not need them or for work they are not really performing. 

The controversy surrounding New York’s Medicaid “racket” provides another reason why Republicans cannot embrace the leftist rhetoric about “cuts” to the program. Cracking down on the potential waste that has led to an explosion of home health aides in New York in recent years — and a 17 percent increase in outlays in next year’s budget alone — isn’t about “cutting” anything other than fraud.