WASHINGTON, July 10 — Mia Dell, policy director at the Service Employees International Union, has issued a public comment on the Office of Management and Budget notice entitled “Methods and Leading Practices for Advancing Equity and Support for Underserved Communities through Government”. The comment was written and posted on July 6, 2021:
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The Service Employees International Union (SEIU) submits these comments for the Office of Management and Budget’s (OMB) Request for Information (RFI); Fed. Reg. Vol. 86, 24029 (May 5, 2021). SEIU is a union that represents over 2.2 million working men and women in health care, the public sector, property services and other service and care jobs including homecare workers, child care providers, janitors, security guards, and airport workers. The majority of our members are people of color. In 2016 our union resolved to become an anti-racist organization; we envision a world where racial and economic equity prevails, where all of us can participate, prosper and reach our full potential./1
We are heartened that OMB and other executive departments and agencies are attempting to identify how they could better advance equity and support underserved communities. The federal government played a role in creating and perpetuating structural inequities, and it should work towards ending them. Many of the social programs and laws that we associate with benefiting working people–Social Security, the National Labor Relations Act, the GI Bill, the Affordable Care Act, the International Covenant on Economic, Social, and Cultural Rights Article 6: Right to Work–have resulted in inequitable outcomes based on race. They have overwhelmingly benefited white people and significantly contributed to the wealth, healthcare, education and other disparities we see and experience today.
Unions and collective bargaining serve as a counterbalance to economic oppression
Work is a channel through which existing social inequities reinforce themselves. Much of the work our members do–providing childcare, cleaning buildings, driving buses, working in laundries and more–has historically been underpaid and undervalued simply because it’s work predominantly done by people of color and women.
Unions give working people the collective power to negotiate for a fairer share of the profits our work produces. Over the past 140 years, the successful unionization of workplaces has increased the wages of African Americans, who made nickels compared to their white counterparts, and has raised the floor for anti-discriminatory hiring and benefit distribution labor standards./2
Research finds that, “union-represented workers in service occupations make 52 percent more in wages than their nonunion counterparts”/3 and women’s hourly wage is, on average, five percent higher than non-unionized women./4
Similarly, there is a union wage premium, for workers with disabilities, of nearly 30 percent./5
Wage premiums are only one part of the story. Belonging to a union comes with other ancillary financial benefits for workers of color. For instance, research shows that nonwhite union members have a 50 percent greater chance of having a 401(k) plan, in comparison to their nonunion counterparts./6
Furthermore, from 2010-2016 nonwhite unionized families “had a median wealth that was almost five times as large as the median wealth of nonunion nonwhite families.”/7
Overall, unionization provides workers more income and employment stability./8
We think every worker, no matter their gender, race, sexual orientation, immigration status, or disability status, should have economic security and equity of opportunity, including the chance to join unions. For that reason, workers’ right to join a union is an essential tool in the fight to promote equity.
Equity in the healthcare system
SEIU brings a unique perspective to this issue. We represent more than one million healthcare workers, including approximately half a million home care providers and 150,000 nursing home workers. At the same time, like other unions we are also a purchaser – through our health funds – of healthcare, and other SEIU members who do not have access to these plans rely on Medicaid and Affordable Care Act (ACA) Marketplace plans. We were one of the strongest supporters of passage of the ACA, which had a demonstrably positive impact on inequitable access to health care, and we have been involved in initiatives to address health disparities. We were thus pleased to see that the recent notice of proposed rulemaking that would build on the ACA explicitly mentions Executive Order 13985 and indicates that HHS reviewed department policies as directed by the Order in developing the proposed rule. While acknowledging the importance of reducing barriers to care, we focus our remarks here specifically on the potential policy adjustments that would impact equity in the health workforce, and in particular a segment of the health workforce that has historically been marginalized and excluded from labor and economic protections.
Area 1: Equity Assessments and Strategies
The rulemaking process should be made more accessible
Rulemaking is an important avenue by which both the OMB and agencies can gather information about the concerns of underserved communities. However, this process, carried through the regulations.gov website, while ostensibly open to the public, can be operationally restrictive because of inadequate outreach and confusing and arcane language. Because of this, the OMB and agencies end up hearing disproportionately more from lawyers, well-funded advocacy organizations, and corporate interests, and disproportionately less from individuals from and smaller organizations representing underserved communities. It shouldn’t take a law degree or a public policy degree for someone to know about and understand RFIs and NPRMs, and to write coherent responses to them.
Ineffective outreach is a solvable problem. OMB and the agencies need to go to affected communities for input and feedback, rather than expect them to come on their own. We recommend the OMB speak to advocacy organizations that do outreach well and glean their best practices. For instance, Benjamin Brooks and his team at Whitman-Walker ([email protected]) created guides and social media content to inform smaller community organizations of this OMB RFI, making the RFI easier to understand and submit a comment.
The OMB should incorporate distributional analysis into its assessments
President Biden asked the OMB to generate recommendations to modernize regulatory review in a memorandum./9
This memo tasked the agency with identifying how regulatory review could promote equity, and determining how it could include distributional analysis into its procedures. Adding distributional analysis of the expected effects of policies and regulations, and, just as importantly, calculating the costs of inaction (i.e. not implementing policies and regulations) would be impactful.
Separately, the OMB should recognize that some policies and regulations fall outside of the purview of traditional benefit-cost analysis. Policies in pursuit of equity and/or justice result in significant benefits to individuals and society, benefits which outweigh economic costs.
Agencies should utilize their Offices of Civil Rights more robustly
Agencies should utilize their civil rights offices both in their rulemaking and enforcement. Rules and standards should be reviewed by civil rights offices before they are finalized. Civil rights offices should also be actively engaged in agencies’ enforcement work.
Collect better demographic and economic data on publicly funded direct care workforce
There is a basic need to collect better demographic and economic data on the publicly funded direct care workforce (especially but not only Medicaid-funded home care), with attention to different service delivery models and employment models (note that a substantial portion of home care workers…