Texas Associates Blog

There has been much speculation about the changing face of health care in the United States since the Affordable Care Act was passed by the Obama Administration in 2010. Divided opinions on the provisions of ‘Obamacare’ have been well-represented by the rife inconsistency across the nation with regards health care exchanges, with some states opting for state-based exchange system, while other states have opted for federal-based initiatives.

As the October 1 deadline draws nearer, much of the attention has focused on the requirement for all US citizens to carry health insurance coverage and the bearing that will have on employers. The reformed regulations are also expected to affect workers’ compensation insurance but the extent, nature and desirability of this impact remains markedly unclear. In the meantime, here are some changes in Workers’ Compensation we are sure to see.

Fewer claims

Each year, millions of workers’ compensation claims are filed, costing employers billions. However, not all of these claims are due to work-related injuries. In some cases, employees without adequate insurance coverage would opt to use their workers’ compensation coverage to cover treatment for various conditions that may be pre-existing. Under the Affordable Care Act, a large contingent of previously uninsured workers will have the right to health insurance coverage of some form or another, thus reducing the need for workers’ compensation claims.

The increase in insured employees will also lead to a preventative approach, from both employers and the workforce, all aiming to develop a healthier workplace and lower the number of filed insurance claims. For Businesses, taking a preventative approach by introducing initiatives such as wellness programs should be regarded as something they do FOR employees and not TO them. At the end of the day, a healthier workforce means health insurance claims are less likely, while taking an interest in the well-being of the workforce can also help harness working relationships and ultimately lead to better results.

Better Care

The Affordable Care Act legislates for an increased number of insured US citizens and in light of this increase, the number of practitioners and physicians is set to also increase, particularly in rural areas. While there have been suggestions of how the actual care will be affected by a much higher proportion of patients, the long-term ideals of the ACA include increased facilities and medical professionals, which will ultimately result in better care in some areas that may have lacked facilities in the past.

The provisions of the ACA also dictate the introduction of Electronic medical records allowing Physicians to diagnose and treat workers’ compensation claims more efficiently and accurately. This emphasis on the holistic treatment of chronic care could ultimately help claimants to return to work quicker, thus benefitting Businesses. An electronic database could also help reduce the likelihood of medical errors and subsequently increase the quality and efficiency of care.

While speculation over how the ACA will affect workers’ compensation coverage continues, it is important for Businesses to understand that there will be changes. Understanding mandate deadlines and the provisions of the act itself is one thing, but understanding the actual effects of Health Care Reform is another, which will involve time, effort and commitment from employers.

If you’re looking to review your Employee Benefits program ahead of January 1, why not ask one of our experts for their advice.