Just six months after the Michigan Legislature had enacted a right-to-work law, the president of the Michigan Education Association presented an optimistic view about the MEA’s prospects. Steve Cook, then the MEA president, said he would not have been surprised if no unionized school employees had stopped paying dues and fees to his union, which the new law permitted them to do.

Six years later, the MEA has had to settle a lawsuit brought by former school employees who had stopped paying dues, though not in the precise manner the state’s largest union dictated. Those 13 individuals were among the 32,028 school employees who have withdrawn from the MEA since Michigan’s right-to-work law went into effect, reducing by 27% the number who are still paying it dues and fees.

The settlement, which was announced Sept. 12 by the National Right to Work Legal Defense Foundation, requires the MEA to cease its demands and expunge “report[s] . . . of nonpayment of dues.” The foundation represented the 13 former MEA members whose election to leave the union was not made during the one month a year it had said resignations were allowed.

The settlement is part of a string of court losses and embarrassments suffered by the MEA after it adopted a hard-line strategy in the wake of the state’s right-to-work law.

In December 2012, Cook outlined the MEA’s strategy, shortly after then-Gov. Rick Snyder signed right-to-work legislation into law. “The membership application signed by every member indicates that if they wish to resign their membership, they must do so in August – and only August,” Cook wrote in a memo. “We are sticking to that. We will use any legal means at our disposal to collect the dues under signed membership forms from any members who withhold dues prior to terminating their membership in August for the following fiscal year.”

In 2015, though, the union suffered a legal setback at the Michigan Employment Relations Commission, which oversees state labor policy. Two years later, it received another defeat at the Michigan Court of Appeals, which unanimously confirmed that its policy was illegal. The court ordered the MEA to admit in its own online magazine that it had committed an unfair labor practice by only allowing its members to leave during the month of August.

Even while the Court of Appeals was reviewing the labor commission’s 2015 ruling, the MEA took another step to make it harder for members to leave.

It established an obscure address, using a post office box, as the only place school employees could send requests to opt out of paying dues. The MEA refused to accept opt-out letters sent to its East Lansing headquarters.

Between 2012 and 2014, the MEA’s main strategy appeared to be aggressive debt collections and legal actions against school employees who did not follow its opt-out rules.

For example, in 2014 the union paid $152,554 to a collection agency to go after school employees who stopped paying, as the law allows. Cook publicly insulted individuals who stopped paying by calling them “freeloaders” in newspaper columns he wrote. Many MEA local affiliates bullied school employees who opted out by posting their names in union newsletters and on written lists in teacher lounges.

At the same time it was using these strong-arm tactics, the MEA’s official stance was that it wouldn’t lose many dues- and fee-paying school employees. Almost all regular school district employees are, as was the case then, in workplaces that have been organized by the MEA. Few charter schools are unionized, however, and Detroit teachers belong to an arm of the American Federation of Teachers.

The MEA stated in October 2013 that right-to-work would have little impact on its membership. Cook claimed that 99% of unionized school employees had elected not to leave in the six months after right-to-work became effective.

On Oct. 4, 2013, Cook said in a taped interview that he would not have been surprised if the MEA didn’t lose any members after right-to-work became effective. But he also talked about the possibility of losing thousands of members.

“That’s everybody’s worst fear,” Cook said.

The MEA had 117,269 active members in 2012, the year right-to-work legislation was passed. It reported having 85,241 members in 2018.

The MEA didn’t respond to an email seeking comment.

Michigan health care regulators are set to meet on Sept. 19 to adopt restrictions on would-be providers of a new cancer treatment. The move, critics say, is redundant, expensive and designed to serve the interest of major hospital chains rather than patients.

The rule involves CAR T-cell therapy, an evolving treatment that uses a modified form of a patient’s own blood to attack his or her specific cancer. The Michigan Certificate of Need Commission, a government agency whose members are appointed by the governor, may end up requiring third-party accreditation for providers seeking to use the treatment.

The rule is backed by Michigan’s largest hospital systems. But it is opposed by cancer research organizations, patient advocates and pharmaceutical companies, who argue it would add an unnecessary level of regulation and deny many patients access to potentially life-saving treatment.

Michigan’s proposed cellular therapy rule could effectively limit the providers of the treatment to large hospital-based cancer centers, opponents said.

“That might not be a big problem for patients in Detroit,” said Dr. James Essell, an Ohio-based blood cancer specialist. “But for people removed from urban centers who don’t have the resources to move for treatment, it could be insurmountable.”

Essell, who filed an objection to the rule with the commission on behalf of The US Oncology Network, said it may be the first of its kind in the country. Opponents of the rule question whether the commission has the authority to regulate CAR T therapy. Its primary jurisdiction is in determining which facilties can obtain hospital beds and major diagnostic tools like imaging equipment, and in what quantities.

For the most part, drug treatments fall under the regulatory purview of the federal government, primarily the FDA.

Supporters of the proposed rule, such as administrators at the University of Michigan Health System, say it is necessary for patient safety. Given the complexity of gene therapy products, they told the commission in a letter, federal oversight is inadequate.

Bret Jackson is the director of the Economic Alliance, a Michigan coalition of business and labor interests. He said the very fact that CAR T and other cell-modification therapies are rapidly advancing is an argument for state intervention.

“The future of these (treatments) looks like it could be very broad,” Jackson said, “You want people (administering them) who know what they are doing.”

The controversy highlights long-standing questions about the validity of Michigan’s certificate of need law, commonly known as CON. It was was enacted in the 1970s under a since-repealed federal mandate, with the intent of controlling health care costs. Fifteen states have subsequently jettisoned the concept.

Michigan’s regulation remains among the most restrictive in the nation, and a 2015 study by the Mercatus Center at George Mason University found it limited the availability of hospital beds and diagnostic services. The law essentially requires prospective clinics, hospitals and certain other medical care service providers who want to open a new facility or expand an existing one to get permission from a commission comprised of existing providers.

Under the state law that created the commission, a new standard, such as the cell therapy regulation, is subject to a veto by elected officials. It can be rejected by the governor or by a concurrent resolution of the state Legislature during a 45-day window after the commission adopts it.

This latter point could mean trouble for the proposal. Among those who filed objections to the rule were three Republican leaders in the state Senate. Senate Leader Mike Shirkey and Sens. John Bizon and Curtis VanderWall said the new rule “will be an onerous barrier to access, create an onerous financial burden for providers, and limit the sites of care from offering cellular therapies to patients.”