Category Archives: Medicaid

Possible Medicaid expansion could impact workers’ compensation, labor markets

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State Sen. Adam Morfeld of Lincoln has helped lead the charge for Medicaid expansion in Nebraska.

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.

Workers Compensation

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.

Employee-Employer relations

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.

 

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Not Expanding Medicaid: Deadly Consequences

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Today’s post comes from guest author Charlie Domer from The Domer Law Firm in Milwaukee.

As previously discussed in my blog post from last year, Nebraska’s Gov. Heineman has refused to expand Medicaid under the Affordable Care Act. Although the Legislature attempted in 2013 and 2014 to expand Medicaid, it has not passed with a filibuster-proof majority.

Whether it is for politics or short-sightedness, Heineman misses the positive impact an expansion of Medicaid would mean to all of Nebraska, including its working families. The benefits of expanding Medicaid to Nebraska’s workers are outlined here.

As I wrote almost a year ago, and as Mr. Domer’s blog post below suggests, the governor’s response in this 2013 Omaha World-Herald article of essentially “eat an apple a day” and go ask your church for some help just doesn’t cut it anymore. I don’t know of too many churches handing out health coverage for an emergency appendectomy or for melanoma screenings. The coverage gap of when a person isn’t eligible for subsidies but would have been eligible for expanded Medicaid looms large for many families and workers: many of them will go without health insurance altogether.

Because there are definitely Nebraskans who are “too poor for Obamacare and … too rich for Medicaid,”even though they’re working, they can look forward to potential “dire health consequences,” as Mr. Domer writes, without insurance. I hope the 2015 Nebraska legislative session will be the year for more working Nebraskans to improve their health through the Unicameral passing expanded Medicaid coverage.

Please take a moment to ready this story out of Pennsylvania: Study: Many Will Die if Medicaid is Not Expanded.   As part of the Affordable Care Act (“Obamacare”), an expansion of Medicaid was intended.  Medicaid essentially is the joint federal-state program to provide health insurance to low income individuals and families.   The federal government strongly encouraged this expansion by the states, by offering to pay for that expansion for many years.   Unfortunately, the US Supreme Court–in upholding the constitutionality of the bulk of Obamacare–did strike down this Medicaid expansion.  The Supreme Court decision left it up to the state’s themselves to decide whether to expand Medicaid for their residents or not.

In many Republican-led states, the decision was made to not expand Medicaid.  As seen in this article, Pennsylvania was a state that declined to expand.  Wisconsin, with Republican Governor Scott Walker, also decided not to provide this expanded Medicaid coverage to the the state’s low income individiduals.  (Check out the story here and here.) 

Now comes news that failure to expand Medicaid may actually result in increased deaths among the affected population.  The failure to have this expanded coverage, according to the study examining Pennsylvanis, will result in thousands of deaths due to individuals foregoing necessary medication, medical treatment, and preventative screening. Additionally, the expansion failure will result in “catastrophic medical expenses and tens of thousands of cases of untreated depression, diabetes and missed screening tests.”   This is a truly scary scenario–and an avoidable one.

In Wisconsin, Gov. Walker is suggesting that these individuals can now obtain health insurance throught the federal-run exchanges.  The real issue is whether these low-income individuals can truly afford the premiums and whether they actually qualify for the federal subsidies.  These lower-income individuals were the one supposed to be covered by Medicaid expansion–not by the exchanges.    Based on the Pennsylvania study, if these individuals are ineligible for Medicaid and cannot secure health insurance elsewhere, dire health consequences (or even death) loom as possibilities.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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