New York’s Massive SEIU Home-Care Drive Is a Preview of Wisconsin’s PPL Future

New York is a Preview of Wisconsin's PPL Future

New York’s largest health-care union just confirmed what MacIver’s months-long reporting about Public Partnerships LLC has been warning Wisconsin about: a massive end-run around Act 10 is coming—potentially busting the state budget and harming at-risk patients in the process. 1199SEIU announced it has enough authorization cards to trigger a union election covering roughly 190,000 home-care workers in New York’s Medicaid-funded Consumer Directed Personal Assistance Program. By some measures, this constitutes the largest single union drive in the United States this century.

Although they are providing service for a state program, the workers are on PPL’s payroll. That is the point.

In New York, the legislature went from hundreds of contractors to one private company to run the payroll for all the state’s home-care workers. Not only was that a win for PPL, who won the contract despite a troubling track record including allegations of bid rigging—it was a win for the union as well. Instead of trying to launch unionization drives across a patchwork of agencies, it only had to organize one employer. And wouldn’t you know it: PPL has already signed a neutrality agreement with 1199SEIU and provided worker contact information that made a statewide card campaign possible.

This is a crystal clear view into Wisconsin’s future. In January, the state Department of Health selected PPL to be the fiscal employer agent for IRIS, the state’s self-directed Medicaid long-term care program serving about 30,000 older adults and people with disabilities, going from three to one employer in the process. Unsurprisingly, competing vendors protested, citing PPL’s legal and operational issues in other states. At MacIver, we have documented PPL’s payroll and transition failures, including Missouri’s quiet cancellation of a PPL contract, and the U.S. Department of Justice’s lawsuit alleging a “sham” bid process around New York’s PPL deal.

Patients and their advocates have spoken out as well, expressing concerns over the loss of choice and PPL’s recurring problems paying employees.

None of that has stopped the Evers administration from pressing ahead, putting a program already running well above $1.4 billion a year in the hands of a company with a checkered track record.

An end-run around Act 10

Home health and personal care aide is the most common job in Wisconsin. The Bureau of Labor Statistics counted nearly 75,000 of those workers in the state. Under IRIS, participants hire their own caregivers, oftentimes family members, and a company called a fiscal agent handles payroll. If PPL becomes that sole agent, those workers would have an employment relationship with PPL, not with the State of Wisconsin.

That distinction matters. Act 10 still constrains public-sector collective bargaining. But private-sector employees of a single out-of-state vendor are a different story. A PPL monopoly would give SEIU a Wisconsin-sized bargaining unit without ever having to reopen Act 10. Higher bargained wages and benefits in a Medicaid program do not come out of corporate profits. They come out of the state budget, which means they come out of the pocket of taxpayers.

And there is reason to believe SEIU may have played a role in the Evers administration’s decision to go from multiple to one provider.

State lobbying records show SEIU Wisconsin State Council registered to support “Long Term Care” policy and funding matters, to work on development or introduction of Wisconsin-specific long-term care proposals, and to monitor DHS wage-boost plans for direct-care workers serving older adults and people with disabilities. Its registered lobbyist is Gary Goyke, a former Democratic state senator and longtime Madison influence player.

The union’s record with PPL is not theoretical. The New York Post reported that 1199SEIU, which claims more than 450,000 members, pressed prospective bidders to accept unionization of some 200,000 CDPAP workers and to join the fight for higher wages. The Empire Center put the motive in plain language: putting a single company in charge of a multi-billion-dollar program “would pave the way for 1199 to unionize hundreds of thousands of CDPAP caregivers, vastly expanding both its membership and its dues revenue.” New York Focus later reported that the union and PPL coordinated lobbying and public messaging while the contract was being locked in.

Costs are already climbing. A union contract would lock them in.

Wisconsin does not need a New York-sized experiment to know where this leads. Gov. Evers and DHS already increased IRIS funding by about 24 percent in the latest state budget—from $1.24 billion in 2024-25 to an estimated $1.54 billion in 2026-27. That is before a single statewide bargaining unit exists. Once PPL is the employer of record and SEIU is at the table, wage floors, benefit packages, and dues deductions become recurring claims on Medicaid. New York’s program ballooned into an $11 billion line item. Wisconsin is smaller, but the mechanism is identical.

MacIver has argued from the start that DHS should not finalize this contract. The protests from competing vendors, the Missouri cancellation, the New York payroll chaos, the federal lawsuit, and now the largest unionization drive of the century are not separate stories. They are the same story. Consolidate the workforce under PPL, and the union follows. The union comes, and the bill to the taxpayers follows.