Unions spent years draining Medicaid money meant for the elderly and disabled straight into its own bank account.
Now Dr. Oz has those nine states cornered with a demand they cannot ignore.
What he is forcing nine governors to hand over could unravel the Democrat Party's most lucrative money machine.
The SEIU Dues Skim That Drained Medicaid Money From Family Caregivers
A woman quits her job to move in and care for her elderly mother.
Medicaid sends a modest monthly stipend to help cover the cost of that care on the idea that paying for a family member to provide care is cheaper than assisted living.
Union Bosses at the Service Employees International Union saw that stipend and decided it belonged to them.
The scheme required one legal fiction. Big labor lobbied Democrat-controlled states to reclassify family caregivers as government employees – not because they work for the government, but because that designation allowed the SEIU to unionize them and tap directly into their Medicaid payments for union dues.
The woman caring for her mother is now, on paper, a state employee.
She never voted for this. In Michigan, only 12.7% of eligible caregivers voted in the SEIU's most recent union election. Tens of thousands were swept in anyway.
Then the dues skim begins. In California, Illinois, Washington, Oregon, Massachusetts, Connecticut, Minnesota, New York, and Missouri, the state intercepts a portion of each caregiver's Medicaid payment before it ever reaches the worker – and wires it straight to the SEIU.
In Washington alone, this arrangement funneled $27 million a year into SEIU coffers. In Michigan, a similar scheme diverted $34 million over a decade – and the union admitted in court that a primary purpose of those dues was influencing elections.
That money was supposed to help Americans care for their parents and grandparents at home. Instead, it bankrolled Democrat campaigns.
Why does a woman receiving a Medicaid stipend to take care of her elderly mom need union representation she never asked for?
The Supreme Court drew a hard line on this in 2018. Janus v. AFSCME ruled 5-4 that public sector workers cannot be compelled to subsidize a public sector union without their clear, voluntary consent. Forcing workers to fund political speech they oppose violates the First Amendment.
Eight years later, Democrat-controlled states are still running the scheme.
Oz Gives Governors Six Weeks to Prove Compliance
Dr. Oz sent letters this week to the governors of all nine states demanding a full audit of their Medicaid programs.
His message was direct. States must prove that home health workers gave clear, voluntary consent before any dues were deducted from their paychecks — and that workers can revoke that consent at any time.
"As part of CMS's ongoing efforts to crush fraud, waste, and abuse in the Medicaid program, we recognize the need to further understand the role that unions play in your state," Oz wrote.
He cited both the Janus ruling and the Biden administration's own 2021 regulation – which requires worker consent before any third-party payment is made from Medicaid funds. States had the legal standard. They chose to ignore it.
Oz made clear there is no grace period. "You must terminate impermissible dues-related payment structures," he wrote.
The audit results are due August 6.
How Union Dues Became a Tax on Medicaid Home Health Workers
Roughly 3.2 million home health workers in the United States are reimbursed by Medicaid — hired directly by their clients, often family members caring for a disabled or elderly loved one.
That Medicaid payment is not a union paycheck. It is money Congress appropriated to provide in-home care for Americans who cannot care for themselves.
For years, SEIU arranged for Democrat-run states to intercept that money before workers ever touched it — wired straight to the union before the caregiver saw a dime.
Oz's audit targets this mechanism directly. CMS wants documentation that states actually collected consent — and enforced it.
That is not a union. That is a payroll deduction operation for the Democrat Party.
SEIU Funneled Medicaid Dollars Into Democrat Campaign Accounts
SEIU Healthcare of Michigan gives nearly 100% of its political donations to Democrat candidates. SEIU 775 in Washington spent $1.9 million to pass a ballot initiative specifically designed to shield union membership records from public disclosure – after losing a court case that would have allowed workers to opt out.
Oz's audit cuts off a pipeline that has been running Democrat campaign cash through federal poverty programs for two decades.
The Biden administration quietly finalized rules in 2021 requiring consent. States ignored the requirement because no one was checking.
Dr. Oz is checking now.
Sources:
- Gabrielle M. Etzel, "Dr. Oz Demands Fraud Audits of Union Dues of Home-Health Workers," Washington Examiner, June 24, 2026.
- "Janus v. AFSCME," Liberty Justice Center, libertyjusticecenter.org.
- "Feds Officially End the SEIU Dues Skim of Medicaid Funds," Washington Policy Center, May 2019.
- "Caregivers Pay SEIU Dues for No Real Union Benefits," Mackinac Center, January 2026.