Impact of Obamacare on Workers’ Compensation: Decreased Cost-Shifting Predicted

Impact of Obamacare on Workers’ Compensation: Decreased Cost-Shifting Predicted

By John Stahl, Esq.

The fact that the primary provisions of the Affordable Care Act, a.k.a. Obamacare, become effective in January 2014 precludes accurately concluding whether those reforms will reduce increasingly burdensome workers’ compensation costs. Workers’ Compensation Judge David Torrey offers his thoughts regarding this in an article titled “The Affordable Care Act and Effects on the Workers’ Compensation System: In General, Cost-Shifting, and the Implications of Employer-Sponsored Wellness Programs” in the March 2013 edition of the worker’s compensation newsletter published by the Pennsylvania Bar Association.

Torrey’s themes included observing that Obamacare rejected the “24 hour care” approach that referred to combining workers’ compensation and “mainstream” medical care. His description of Obamacare’s objective of outlining “strategies to increase access to affordable, improved care while containing costs” mirrors the objectives of a model workers’ compensation system. Those strategies that are anticipated to affect workers’ compensation costs and claimants’ access to care include:

  • Increased demand for medical care by the general population that may reduce the access to that care within the workers’ compensation system.
  • A larger population of people with group health insurance is predicted to reduce the current practice of shifting the costs of medical care from the mainstream health system to the workers’ compensation system.
  • Injuries that are sustained while participating in employer-sponsored wellness programs, such as exercise sessions, may be considered compensable harm that arises out of the claimant’s employment.

The takeaway from all this is that Obamacare does not focus on workers’ compensation but creates a ripple effect that will likely increase the costs of providing claimants workers’ compensation insurance coverage. The reduction in cost-shifting from mainstream health care to the workers’ compensation system will offset this additional expense.

© Copyright 2013 LexisNexis. All rights reserved.