Democratic strongholds deducted nearly $150 million from Medicaid caregivers’ payments and handed them to labor unions in 2017, according to a report released by the Freedom Foundation.

California, Connecticut, Illinois, Massachusetts, Minnesota, Oregon, Vermont, and Washington deducted hundreds of millions of dollars in union dues and fees last year from federal funds set up to care for disabled and elderly Americans. The dues scheme has taken thousands of dollars from more than 350,000 Medicare providers, many of whom are caring for sick and aging family members. Since the turn of the 21st century, states have siphoned more than $1.4 billion in union dues from care aides’ paychecks, according to the pro-free market foundation’s report.

In 2014, the Supreme Court ruled in Harris v. Quinn that it was unconstitutional for states to force Medicaid caregivers to pay union fees against their will. But some states have created new measures since the decision, working with unions to coerce Medicaid caretakers to pay union dues even if they refuse.

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