Nebraska voters will likely vote on Medicaid expansion in November after Insure the Good Life turned in 135,000 signatures earlier this month. Insure the Good Life estimates 98,000 Nebraskans who aren’t eligible for Medicaid but can’t afford coverage on the ACA exchanges will would get insured if the measure passes in Novmeber.
If Medicaid expands in Nebraska, it could impact the employee-employer relationship and workers compensation in the state.
Expanded health insurance means that more people will have access to medical care and have a relationship with a general practitioner. Oftentimes injures employees don’t have family doctors, so they let their employers pick their doctor by default. Letting an employer pick a doctor in a workers’ compensation claim can be harmful to an injured employee’s workers compensation case.
Access to primary care can also help an injured worker manage chronic conditions such high blood pressure and diabetes that can hinder recovery from a work injury.
An employee who has their workers compensation claim denied and isn’t working is usually unable to afford COBRA coverage — assuming their employer offers health insurance in the foirst place. An injured worker in that situation who is covered by Medicaid can continue to get the medical care they need to recover and develop their workers compensation case.
Employees often put up with abusive employers solely for the sake of health insurance. The option of enrolling in Medicaid would give more employees to take their job and shove it. This concern is part of the allure of portable benefits for employee that I have written about before. Less reliance on employers for health insurance could improve labor mobility and push up wages.
My opinions about the impact of Medicaid expansion in Nebraska come with some caveats. I have long believed the expansion of health insurance leads to more doctor choice for injured workers. But some studies of the ACA show it has lead to consolidation in the medical industry. This consolidation could gut any formal right employees have to chose their own doctors under workers compensation laws because there is less overall choice of doctors. This issue may have to be addressed by more vigorous anti-trust law enforcement
Also, just because a state expands Medicaid by referendum doesn’t mean the elected branches of government will implement the expansion. That is what is happening in Maine. The whole structure of the Affordable Care Act could be altered through another court challenge to the ACA. Finally the Nebraska Medicaid petition has been challenged by opponents of the expansion
But even with those caveats, I believe Medicaid expansion would be a good thing for injured workers and employees in Nebraska.