Supreme Court Upholds Obamacare

Medicare Set-Aside Blog on June 28, 2012 | Posted by


In a 5-4 decision, the Supreme Court today announced that the Affordable Care Act (ACA) is constitutional. The Court upheld the law in its entirety, essentially finding that it is within Congress’ power to tax. Of the four issues considered, the most surprising to be upheld was the penalty for failing to purchase insurance. Justice Roberts commented, “It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance. Such legislation is within Congress’ power to tax.”

The issue is far from over as many have already spoken out about continued efforts to strike down the law, what a critical issue this will continue to be in the upcoming election, and how the ACA will do little to reach its target market. The ACA falls on private sector insurers, and high deductibles, co-pays and coverage gaps will continue to leave millions uninsured.

This is sad day for employers nationwide with 50 or more employees. The federal government has officially taxed us into absorbing the burden of the nation’s health crisis. In addition to carrying workers’ compensation coverage just in case they get hurt at work, employers are now mandatorily required to provide health care for their employees general well being, extend that coverage to their children longer, absorb pre-existing conditions, and nearly double the Medicare contribution so those employees will have medical benefits when they become old or disabled; however, it will be less of them because the ACA also cuts Medicare spending. Short of an unemployment fund assessment to provide medical benefits in the event that you fire someone, there aren’t many scenarios left for an employer to provide medical benefits.

Now, from the workers’ compensation perceptive, these same employers could potentially benefit from a reduction of claims that might otherwise have not originated at work. Many WC claims I see are exacerbations of preexisting conditions that were generally untreated prior to the work incident. That is not to say that these individuals did not have insurance available, but given the national statistics about the number of people who are without, it can be assumed some portion of those claimants were uninsured. Had prior medical care been available and obtained, can it be assumed that the claimant would not have dislocated that disc or joint or simply heard that final pop while at work? Only time will tell.

For the most part, I believe work comp will be business as usual. Even in situations like the one above, WC is still the cheaper treatment alternative because there are no out of pocket expenses and you would get paid for your time off work while obtaining treatment, nto to mention mileage. I think the only area I expect for Obamacare to make a difference is settlements. Parties’ biggest concern in settling meds is obtaining medical care post-settlement, so knowing that they have a fall back available that cannot exclude preexisting conditions may encourage more settlements. Again, only time will tell…