Sean Callagy - Attorney and Entrepreneur: obamacare

Thursday, January 21, 2016

Effects of PPACA on Workers’ Compensation

A closer look into the Universal Healthcare System

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.

This week, Democratic Presidential Candidate Bernie Sanders unveiled his universal healthcare plan aimed to guarantee healthcare as a fundamental right for every American. The Sanders healthcare strategy is to expand medicare and creating a single payer health care system for every American. Sanders, a supporter of the Patient Protection and Affordable Care Act (PPACA), does not feel the PPACA goes far enough to provide the nation with adequate healthcare coverage. To fund the cost of the plan, Sanders plans to increase the top marginal tax rate to 52% for income over ten million dollars and by imposing a 2.2% flat tax on all income beyond the standard deduction.

The PPACA, also known as “Obamacare”, was enacted in 2010. Obamacare had no direct affect on the United States’ workers’ compensation system. The PPACA is targeted at health insurance, which provides coverage for non-work injuries and illness. The act also does not make any changes to the control states have over their workers’ compensation system. However, some experts believe that the PPACA will have long term indirect effects on the workers’ compensation system. The first of these effects is a decrease in fraudulent workers’ compensation claims. The reasoning behind this effect is that as health care is made more available there will be less motivation to cheat the workers’ compensation system into paying for non-work related injuries. A second effect is that in theory a healthier US population would be less likely to suffer work injuries and, thus, the number of workers’ compensation claims would decrease. Additionally, those workers that do file workers’ compensation claims would need less treatment due to improved overall health. A final and concerning indirect effect is that an increased in the number of insured individuals may overwhelm the healthcare industry and cause greater delays in treatment.

According to a report by the Centers for Disease Control and Prevention there were roughly 11.4 million uninsured Americans as of 2014. Senator Sanders’s “Medicare for All” plan would cover these individuals. Like the PPACA, there seems to be no mention of any direct effects on workers’ compensation but due to the additional number of participants in the system, the indirect effects are likely to be magnified.

We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $185,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

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Friday, April 24, 2015

Is Obamacare in the Supreme Court Again?

The politics of the Affordable Care Act, more commonly referred to as “Obamacare,” never seem to settle. On March 4, 2015, the Supreme Court heard Oral Arguments in the most recent challenge to Obamacare,King v. Burrwell. Some people, who perhaps do not passionately follow constitutional challenges and the like, must be wondering, didn’t we go through this already?

To clarify, Obamacare was challenged in the Supreme Court prior to the pending litigation but on an entirely different issue. In National Federation of Independent Business v. Sebelius, the court weighed whether or not the federal government exceeded its power in mandating that certain Americans purchase private health insurance. This landmark case was decided on June 28, 2012 with the court ultimately concluding that requiring the purchase of health insurance was within the scope of federal authority under the taxing and spending clause of the constitution. This was a rather fascinating ruling in that most assumed that any power to mandate the purchase of a private commodity would stem from the commerce clause rather than from taxation. (Perhaps I use the word fascinating too loosely.)

By contrast, the current litigation pending in the Supreme Court essentially rests on a technicality. A core tenet of Obamacare is the availability for Americans to purchase health insurance in government run exchanges and receive government financed subsidies to help offset the cost of health insurance. The legislation called for every state to establish a “state run” exchange and for the federal government to establish a federal exchange as well. The purpose of the federal exchange is to service those Americans who reside in a state that failed to establish an exchange.

What led to the current Supreme Court case has to do with the way the legislation was drafted with respect to the availability of subsidies. The language of the statue calls for subsidies to be made available for those who purchase health insurance through an exchange “established by the state.” The plaintiffs thus argue that the legislation never intended for subsidies to be made available for those who purchase insurance through the federal exchange, but rather, subsidies are reserved for state run marketplaces.

The implications of this case are quite significant as only 21 states have set up their own exchanges. As a result, should the Supreme Court strike down federal subsidies, residents of 29 states would lose access to Obamacare subsidies. Unfortunately for any New Jersey resident relying on these subsidies, New Jersey has not established its own insurance exchange.

However, many see the likelihood of the Supreme Court siding with the plaintiffs in this case as quite slim and attribute the language in the legislation referring to an exchange “established by the state” as sloppy drafting. A primary purpose of Obamacare was to ensure access to health insurance through the availability of government subsidies; why then, they argue, would Congress not intend for subsidies to be made available through the federal marketplace?

Whatever the court concludes, one thing is certain: Americans will be debating the merits of Obamacare long after the ruling.