On May 2, 2019, the Trump administration launched its latest attack on some of the most vulnerable members of the working class when the Centers for Medicare and Medicaid Services (CMS) issued a new rule that unions say will specifically target home care workers and their ability to organize by making it more difficult for them to pay union dues.

Home care workers are trained professionals who provide in-home care, companionship, and medical support for the millions of elderly people, injured people, and people with disabilities who need those services. They serve an extremely important role in our society, yet their labor is shockingly undervalued: the median wage for home care workers is only $13,000 per year, and over half depend on some form of public assistance to get by. The majority of them are women of color, and many are immigrants.

Their services are becoming increasingly crucial. In a post-Baby Boomer world, the United States population is aging fast; 10,000 people turn 65 every day in America, and by 2050, the number of Americans over 65 will double to 88 million, while the population over 85 will more than triple in the same time period. In addition, by 2040, there will be more than 50 million people with disabilities who need long term care. Home care workers and their labor are what allows people with these needs to remain at home instead of being placed in a nursing home or other institutions, and ensures that those needs are met when family members are unable to step in.

The industry includes more than 2 million workers (almost a million of whom are members of the Service Employees International Union) and is the fastest-growing occupation in the U.S., and will comprise the largest workforce in the country by 2026. It is work that’s largely government-funded via Medicare and Medicaid, which the Trump administration has long been vocal about its goal to cut.

The latest rule, which came a mere 24 hours after International Workers’ Day, was in the works for months.

Under the new Medicaid Provider Reassignment Regulation, states will be unable to make Medicaid payments to third parties like health insurance providers or unions on behalf of an individual worker. This means that 800,000 home care workers will now be blocked from deciding how to spend their own wages by using payroll deductions, which are a common way for workers in various industries to contribute money directly from their own paychecks for benefits like health insurance, retirement plans, or, in the case of many organized workers, union dues.

“The workers who typically provide home care are mostly women and people of color,” Virginia Grant, a home care worker and member of SEIU Healthcare Illinois, said in an SEIU Communications press release. “Already we’re making less than other professions and less than men overall. This attack by the Trump administration is an attack on us, our consumers, and our ability to improve our jobs. It’s not right and it’s not fair.”

The transient, part-time nature of home care work can already make it tough for workers and unions to connect; coupled with the fact that many low wage workers don’t have bank accounts, and adding an extra layer of red tape — plus the potential threat of overdraft fees if they do have one — this latest rule places a cruel burden on the shoulders of working people who are trying to build better lives for themselves and their coworkers.