Hochul's 'Anti-Fraud' Scheme Backfires, Gifting Monster Union

New York's 1199 SEIU union set to grow by over 50% thanks to Hochul's Medicaid reforms.

Published on Mar. 2, 2026

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Governor Kathy Hochul's efforts to rein in fraud in New York's Medicaid program have backfired, resulting in a massive expansion of the powerful 1199 SEIU union. By centralizing payments to home health aides through a single company, Hochul has inadvertently allowed these workers to be classified as employees and thus eligible to unionize with 1199 SEIU. This could swell the union's ranks by over 50%, giving it even greater political influence and financial resources to wield in Albany.

Why it matters

1199 SEIU is already one of New York's most powerful unions, wielding significant political influence. This expansion will further strengthen the union's position, allowing it to demand higher wages and benefits for its members at taxpayer expense. It also raises concerns about the union's ability to push its broader political agenda, which often goes beyond the interests of healthcare workers.

The details

Hochul's 2024 reforms to the Consumer Directed Personal Assistance Program, aimed at curbing fraud, have had the unintended consequence of funneling home health aides into 1199 SEIU. By hiring a single company, Public Partnerships, to centralize payments, these aides are now considered PPL employees and eligible to unionize. 1199 SEIU has already begun a campaign to organize an estimated 250,000 of these workers, which would swell the union's membership by over 50%.

  • In 2024, Hochul pushed through reforms to the Consumer Directed Personal Assistance Program.
  • On March 1, 2026, the Empire Center's Bill Hammond publicized a letter notifying home health aides they'll soon be able to decide whether to join 1199 SEIU.

The players

Kathy Hochul

The Governor of New York who pushed through reforms to the Consumer Directed Personal Assistance Program, inadvertently allowing home health aides to be unionized by 1199 SEIU.

1199 SEIU

A powerful healthcare workers union in New York that is poised to grow its membership by over 50% as a result of Hochul's Medicaid reforms.

Public Partnerships

The company hired by New York to centralize payments to home health aides, which has allowed these workers to be classified as PPL employees and thus eligible to unionize.

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What they’re saying

“A campaign by 1199 SEIU to organize roughly a quarter-million home health aides has begun in earnest.”

— Bill Hammond, Senior Fellow, Empire Center (Empire Center)

What’s next

Federal investigators are probing alleged bid-rigging in the awarding of the single-payer contract to Public Partnerships, which enabled the unionization of home health aides.

The takeaway

Hochul's efforts to curb Medicaid fraud have backfired, resulting in a massive expansion of the powerful 1199 SEIU union. This will further strengthen the union's political influence and ability to demand higher wages and benefits at taxpayer expense, raising concerns about the union's broader agenda in Albany.