Workers Comp Zone


Paul Ryan’s plan to gut and amend Obamacare is now on the table. What are the implications for California workers’ comp?

The American Health Care Act, aka AHCA or Ryancare, faces political hurdles in the next few weeks. Today it did survive a vote in the House Budget Committee, but it faces uncertain support in the House overall, with opposition from some GOP Freedom Caucus members.  And Ryancare may have tough sledding in the U.S. Senate . Many GOP senators appear concerned about the March 13, 2017 Congressional Budget Office report (see link below) indicating that millions would lose health coverage.

So its almost certain that we will see amendments as AHCA goes through the legislative process before it finally becomes Trumpcare.

As with any plan, there will be winners and losers.

But the CBO report is a real stunner. It should be required reading for anyone involved in handling injury claims.

As the CBO report indicates, older individuals with lower incomes fare poorly under AHCA. Insurers will be able to raise insurance rates and cuts in tax credits will disproportionately affect  lower income folks and older people.

The Henry J. Kaiser Family Foundation has developed an online county-by-county calculator (see link below) which demonstrates the changes in tax credits using different age and income assumptions.

And cuts to Medicaid will cause huge numbers to lose insurance they have.

The CBO estimates that by 2018, 14 million more people will be uninsured under the legislation than under current law. That number would grow under Ryancare to 21 million in 2020 and to 24 million in 2026.

What are the implications for workers’ comp?

First, a word search of a pdf of Ryancare does not reveal any mention of workers’ comp. So it appears that Ryancare as currently envisioned would not directly address the issue of workers settling comp cases and then using their Ryancare coverage.

Second, it seems likely that Ryancare would encourage many workers to seek treatment for various conditions through workers’ comp. If 24 million currently insured folks lose that coverage, many of them are going to seek treatment wherever they can get it. That may mean more claims for cumulative trauma. It may mean more claims for collateral health conditions as workers seek to find a source of treatment for illnesses on a compensable consequence theory.

Third, as more workers lose health coverage, it seems likely that we will see in workers’ comp more workers with underlying, untreated health issues. This may increase claim “severity” as co-morbid conditions often make recovery from a work injury more difficult.

Fourth, eliminating some of Obamacare’s  coverage requirements for things such as preventive care, mental health coverage and drug treatment may steer some towards the workers’ comp arena.

These implications are hard to measure, but likely to have major long term implications for workers’ comp.

Stay tuned.

Here is a link to the CBO report:

Here is a link to the Kaiser Family Foundation interactive tools:

Julius Young