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How Will Affordable Care Act Impact Workers’ Compensation Settlements?

Written by Ankin Law Office

Many of the primary provisions of the Affordable Care Act (ACA) – commonly referred to as Obamacare – will take effect in 2014. Now that the law has been declared constitutional by the U.S. Supreme Court, and given the imminence of many of the law’s provisions, various groups and industries are wondering how the law will impact them.

Although ACA does not directly impact the workers’ compensation system, it will likely have a ripple effect given its direct impact on the health care system as a whole and the delivery of medical treatment. The impact of ACA on workers’ compensation settlements and medical treatment for injured workers remains to be seen, but the following are some predictions from various experts across the country:

  • ACA’s lower Medicare fee schedule could affect reimbursements under workers’ compensation insurance programs by limiting coverage payouts.
  • An increased demand for medical care by the general population could reduce the access to medical care for injured workers within the workers’ compensation system.
  • An increase in the number of people with group health insurance could reduce the current practice of shifting the costs of medical care from the mainstream health system to the workers’ compensation system.
  • Injuries sustained while participating in an employer-sponsored wellness program, such as exercise sessions, could be considered a work-related injury arising out of employment such that the injured worker is entitled to workers’ compensation benefits.
  • Workers’ compensation insurance fraud for non-work-related injuries could decrease since all individuals will be required to maintain health insurance.
  • ACA’s expansion of employer-sponsored preventive health care and wellness services could improve the overall health of workers, thereby reducing the impact of exacerbating medical conditions such as smoking, diabetes, and obesity in connection with workers’ compensation claims.
  • Workers’ compensation insurance premiums could increase for employers, depending on the employer’s compliance with ACA’s requirements to provide employee health care coverage.

All in all, many experts within the workers’ compensation industry anticipate that various ACA provisions – including the law’s health insurance mandate, its focus on wellness programs, and the reduction in cost-shifting between workplace accident medical care and general medical care – will benefit workers’ compensation systems.

At Ankin Law Office, LLC, our Chicago worker’s compensation attorneys are dedicated to helping injured workers get maximum recovery for their work-related injuries through worker’s compensation benefits and any applicable third-party claims. If you have been injured in a workplace accident, do not hesitate to contact our office at (312) 600-0000 to schedule a free consultation with one of our Chicago workplace accident attorneys.