ACA, Medicare southern call centers ring in the first day of open enrollment with a strike

Editor's Note: This story has been updated with a statement from Maximus and new information about the number of workers who went on strike.

Nov. 1 marked the first day of the Affordable Care Act (ACA) open enrollment and the beginning of the largest nonunion strike since the beginning of 2021.

Maximus is the nation’s largest federal call center contractor. Workers from several call centers—in Bogalusa, Louisiana; Hattiesburg, Mississippi; London, Kentucky; and Chester, Virginia—have pledged to strike until they receive a base pay of $25. With a rise in inflation, workers of the Centers for Medicare & Medicaid Services (CMS) contractor wrote in a press release that they have struggled to provide the care necessities for their families. Maximus workers are organizing with the Communications Workers of America (CWA).

“We don't want to patch; we want a new foundation,” Tiffany Murray, a worker in the Hattiesburg call center, told Fierce Healthcare. “Fix a flat, we don't need that. We need a whole new tire moving forward. So going out is going to show them that you can't just pacify us with a bonus. We need our rights.”

CWA estimated that over 650 workers at Maximus call centers charged with meeting the influx of open enrollment calls went on strike in search of fair wages and treatment. 

Maximus informed Fierce Healthcare that it does not have a record of 650 callers going on strike. The company stated that less than 200 callers out of their worker base of 11,000 employees went on strike. 

During open enrollment, call volume substantially increases in facilities that handle Medicare and ACA Federally Facilitated Marketplace calls. Maximus workers also demand clear policies protecting them from abusive calls, such as the ability to disconnect or escalate calls immediately without fear of punishment. 

Workers also claim that management has been largely dismissive of racial and sexual harassment from callers. For this reason, their third demand is 30 minutes of allocated time within an eight-hour shift to compose themselves between calls.

A spokesperson for Maximus clarified that the company has not seen an increase in abusive or obscene calls. In an email, the spokesperson stated that the company has standard operating procedures to protect employees including recording all calls and empowering employees to end calls when a caller is persistently inappropriate, obscene, disrespectful or derogatory. Employees are not required to seek permission from supervisors to disconnect calls nor warn callers that the call is being terminated, according to Maximus. 

ACA enrollment takes place annually between Nov. 1 and in most states lasts until Jan. 15. To access coverage that begins Jan. 1, members must enroll by Dec. 15. ACA coverage helped the nation reach a near-record low uninsured rate with 35 million patients being covered in 2022. Coverage increased by 27 million since 2020.

The Virginia-based employer maintains one of the largest federally contracted workforces in the country through its call center contract with CMS.

"The first day of open enrollment for coverage under the Affordable Care Ace was a success, with no disruption in service for tens of thousands of Americans seeking to sign up for these essential benefits. More than 95% of consumers reported they were satisfied with the service they received, the Maximus spokesperson said, noting that the company's employees handle more than 35 million calls a year from those seeking ACA coverage through the health insurance marketplace as well as information about Medicare coverage.

CWA states that the current base pay rate at all Maximus CMS call centers is about half the wage rate needed for a parent with one child to meet minimum standards of living, a dollar amount determined by the MIT Living Wage Calculator.

Eight out of 10 Maximus call centers are located in Southern states where inflation increased costs by 8.7% last year, with the price of groceries increasing by 13.2%, household energy costs by 19.9% and gas by 13.9%.

“It is not by accident that Black women from Mississippi and Louisiana are the ones to call out this injustice of our system that expects them to be essential workers but does not treat them as human beings who matter,” said Charles Taylor, executive director of the NAACP Mississippi state conference, in a press conference with Maximus workers and CWA. “We are seeing the consequences of generational divestment and leadership falling heavy on predominately African American communities.”

Maximus workers at the relevant call centers were offered $200 from management if they did not join the strike, according to the striking workers.

A spokesperson from Maximus wrote in an email that it is "not uncommon for employers including Maximus to offer an attendance incentive program for all workers on critical days, like Tuesday - the first day of open enrollment for the Affordable Care Act - when we expected a spike in call volume. Attendance incentives have been used every year since the program’s inception." 

Maximus workers previously wrote letters to their CEO stating that workers delayed healthcare because of the company’s expensive health insurance. In August 2019, workers in a Kansas Maximus facility filed a complaint with the Department of Labor alleging that the company was misclassifying and underpaying its employees, the tenth complaint of such since 2017.  

In 2022, the company made headlines again after workers said they were afraid that co-workers with COVID-19 were still coming into work because they could not afford to take time off.

Steven Meyer, an Oklahoma City Apple employee who was a part of a successful union drive, shared his own experience with Maximus workers during a CWA press conference.

“Over time, I noticed my co-workers at Apple quit not because they liked the job but because their individual efforts to maintain the good parts of it and improve the bad parts got lost in the corporate system of feedback that seems designed to lose such concerns,” Meyer said.

The Apple branch in question was the second of the tech giant’s stores to complete a successful drive since June. Both have yet to receive recognition from the tech giant. In recent months, Apple workers' strikes have spread, most notably in Australia.

Tech employee strikes have increased in recent years with one Amazon fulfillment facility now being unionized. Recent months have also brought the stepping out of healthcare workers, especially nurses and behavioral health providers, demanding better pay and working conditions as burnout soars.