Affordable Care Act and Medicare call center workers strike for better pay and healthcare from Maximus

A call center agent wears a headset at their desk.
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For many employers, 2023 has been a year of reckoning, as over 450,000 workers across the country have gone on strike for better wages and working conditions — and a few hundred more are joining the fight.

Affordable Care Act and Medicare call center workers, contracted under Maximus, the federal government's largest call center contractor, are on strike today across six states, marking their sixth strike since March 2022. This strike comes a month before the open enrollment deadline for the Affordable Care Act marketplace, where Americans can purchase federally-backed coverage. Maximus' workers are calling for affordable healthcare, wages of at least $25 per hour — at least a $6 increase for most workers — protection from unfair layoffs and the ability to organize their union without employer intimidation.

For Katherine Charles, a single mom of two, this strike is well overdue. Charles has worked for Maximus for nearly a decade, helping Americans navigate the Affordable Care Act marketplace and gain access to coverage and care. And yet, she says she still cannot afford to take vacation time with her kids or see a doctor for what should be routine blood work. 

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"We're not asking to become rich. We are asking for an income that will help us support our families," says Charles, who is based in Tampa, Florida. "We are asking to be able to afford rent, to be able to afford groceries without going to the dollar store because we believe our families deserve better than that."

Charles is not alone. The Communications Workers of America (CWA), the largest communications and media labor union in the U.S., and the Strategic Organizing Center (SOC), a coalition of North American labor unions, surveyed 154 Maximus workers across nine states, finding that nine in 10 respondents are primary earners in their household; six in 10 live in households with children under 18. Of those with children, 83% are using one or more federal social safety net programs like the Supplemental Nutritional Assistance Program (formerly known as the food stamps program) to afford their basic needs. 

This is a small sampling for a workforce of 40,000 employees across 21 locations in the U.S. While Maximus declined to speak with EBN on the record for this story, in a statement shared via email, the company points out that in their own Global Employee Engagement Survey, which had 76% participation rate, 77% of their contact center operations employees said they would recommend Maximus as a great place to work.

"There has been a significant amount of erroneous information being distributed, misleading our employees, customers, as well as national and local leaders," Maximus shared in its statement.  "The level of false information is inappropriate and intentionally timed at the expense of 75 million Americans who are navigating open enrollment in Medicare and the Affordable Care Act."

Charles points out that many workers fear what could happen if they speak out against the company. She notes that, in her estimation, a majority of Maximus frontline workers are Black and Latina women located in the South — meaning many of these workers are already at a systemic disadvantage when it comes to pay, healthcare access and career advancement. 

"Many people are very scared to do what I'm doing," says Charles. "They're scared that they're no longer going to have a job, that they're going to be let go. I'm afraid as well."

A federal job without the federal benefits

Depending on the state, base pay for Maximus' call center workers can be as low as $16.20 per hour, with over 90% of the workforce making under $19, according to the CWA and SOC sampling. Workers do not typically see raises unless the Department of Labor requires one from their federal contractors, says Charles. 

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Using the MIT living wage calculator, the CWA and the SOC estimate that workers with just one child living in Tampa's Hillsborough County need to make at least $36.10 per hour to have what's considered a liveable wage. That's distant from the stereotypes that surround federal jobs, which are often lauded for pay, strong benefits and stability — and that's what makes the situation especially frustrating, notes Alex van Schaick, an attorney with the CWA. 

"Employees are really sick and tired of struggling to make ends meet while doing a job for the federal government, which we traditionally think would provide a middle-class life," he says. "Instead we got folks struggling to make it work and delaying medical procedures."

Notably, nine in 10 Maximus workers surveyed by the CWA and SOC report that they have medical debt and have avoided or postponed medical treatment due to costs. Under Maximus' high deductible health plan — whose premiums takes the least from employees' paycheck, according to the CWA — Charles needs to spend $2,000 before her insurance helps cover care. As a result, she has put off necessary doctor visits for over a year and a half. 

Read more: 92% of employers expect more layoffs in 2024

"I help people every day get health insurance with low deductibles and low copays, but I cannot say I have those benefits," says Charles. "I was forced to put my children on Medicaid in order for them to at least be able to get the quality healthcare that they need."

Charles is confident that Maximus can provide better health plans, ones that feature low copays and low deductibles without sky-high premiums. Notably, Maximus did lower its deductible of $4,500 to the current $2,000 in Feb. 2022, according to the CWA. 

"These are folks who are on the frontline making sure our seniors and all people in the U.S. are able to get healthcare," says van Schaick. "It is certainly tragically ironic that the folks who are answering those calls are delaying their own [care] because they can't afford it on their inferior coverage."

The path to union-hood

Maximus call center workers have been working for several years to organize a union, according to both Charles and van Schaick. In that timeframe, the CWA has filed seven unfair labor practices charges against Maximus for their union-busting tactics. These include offering bonuses to non-striking employees, prohibiting CWA union members from talking to employees by blocking parking lot access, threatening to close the Louisiana call center if the local workers formed a union and calling the police on workers striking at the Virginia call center in Aug. 2022. 

The last charge was filed after Maximus laid off 700 workers in May. The CWA reiterated previous examples of unlawful intimidation tactics, noting that threatening employees with layoffs for organizing was one of them. The CWA has also been calling on the Department of Health and Human Services Secretary Xavier Becerra to investigate Maximus for failing to meet the Biden administration's commitments to advancing racial equity and using federal funding to create family-supporting jobs. 

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As part of the workers' demands, protections against unfair layoffs are especially crucial as they continue to work towards unionization, underlines Charles. While Maximus fired both pro-union workers and employees who never got involved in organizing, Charles believes the layoffs in May were still a consequence of workers exercising their right under the National Labor Relations Act to organize and bargain collectively with their employer. 

"The excuse they used to fire all those people was that they didn't need as many people working," says Charles. "But we continued to hire people and bring people on that needed to be trained after letting go of a bunch of people who knew the process and the marketplace."

Essential work

Charles takes pride in advising people on how to choose and navigate their health plans, and she knows many of her co-workers feel the same way. Despite her experiences, Charles underlines how much she loves the core mission of her job: helping people.

"Every day I wake up and I'm able to solve problems for people — someone who has cancer, someone whose insurance company is not allowing them to see a particular doctor," she says. "We love our job. I have a bachelor's degree in another field, but healthcare is fulfilling to my soul. We are helping millions of Americans."

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Maximus's revenue has doubled in the last five years, according to the CWA, but Charles and van Schaick maintain that workers are not compensated accordingly.  

As of early November, Maximus has a net worth of $4.68 billion, which increased by 23% in one year, according to Stock Analysis. Maximus CEO Bruce Caswell made $6.3 million last year, which is 161 times greater than the average salary at the company, according to the CWA. Meanwhile, Charles knows co-workers who have had to move their families into mobile homes because they can no longer afford rent for an apartment.

"The little people on the phone, the ones that actually do the hard labor, we have to make decisions every hour of every day about what we can and cannot do — if we can even take our children out for ice cream," says Charles. "That's not a concern for the CEO." 

Charles fears she may lose her job for speaking out, but she believes it's a necessary risk for the changes she wishes to see for herself, her family and her co-workers. 

"I always tell my children that if they believe something is worth fighting for, to do it," says Charles. "I'm teaching them by example. I believe in fighting for the betterment of not just me but my co-workers. I believe in it, so I'm speaking out on it."

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