The United States Supreme Court agreed to review the decision in Harris v. Quinn.  In that case home health workers who were paid under Medicaid in Illinois were considered to be employees of the state, and, therefore, obligated to take part in the State's collective bargaining agreement which required even non-union employees to pay a "fair share" fee to cover some collective bargaining and union costs.

The plaintiffs argued that since they were not union members, the "fair share" requirement violated their First Amendment rights by compelling their association and speech through the union.  The Seventh Circuit Court of Appeals disagreed with the plaintiffs based on the Supreme Court's earlier holding that employees may be compelled  to support legitimate, non-ideological union activities.  The plaintiff's argued that they were not employees of the state, but rather employees of the patients for whom they worked.  The Seventh Circuit disagreed because the state had significant control over the home health workers' assignments, qualifications, and pay.  They also dismissed a group of plaintiffs that were not currently subject to the collective bargaining agreement because their claims were not yet ripe for review.  

The Supreme Court must now address two issues:  (1) Whether a state may, consistent with the First and Fourteenth Amendments to the United States Constitution, compel personal care providers to accept and financially support a private organization as their exclusive representative to petition the state for greater reimbursements from its Medicaid programs; and (2) whether the lower court erred in holding that the claims of providers in the Home Based Support Services Program are not ripe for judicial review.