Appeals court upholds injunction halting health mandate
Legal Events
A federal appeals court ruled Thursday that President Barack Obama's health care law unjustly burdens religiously affiliated employers by forcing them to help provide insurance coverage for certain contraceptives, even though they can opt out of directly paying for it.
The ruling by a three-judge 8th U.S. Circuit Court of Appeals panel in St. Louis upheld lower court decisions that sided with plaintiffs who included three Christian colleges in Missouri, Michigan and Iowa.
The 25-page opinion conflicts with all other federal appellate courts, which have found in the U.S. government's favor.
As religiously affiliated entities, those colleges victorious with Thursday's ruling don't have to pay directly for their workers' birth control. Instead, they can seek an accommodation that requires their insurance providers to pay for it. But the groups still say the scheme makes them complicit in the providing of contraception and subjected them to possible fines for noncompliance.
Circuit Judge Roger Wollman, writing the ruling on the panel's behalf, wrote that the contraceptive mandate and accommodation process of the Affordable Care Act substantially burdens the plaintiffs' exercise of religion.
Those plaintiffs included Heartland Christian College in Newark, Missouri, Dordt College in Sioux Center, Iowa, and Cornerstone University in Grand Rapids, Michigan, as well as Bethel, Missouri-based CNS International Ministries Inc., a nonprofit provider of addiction services.
The Justice Department, which has called the lawsuits meritless and an attempt to prevent female employees from obtaining coverage, defended the federal government in the cases but directed The Associated Press' questions Thursday to the White House, where a statement called the rulings disappointing.
"As all of the other seven U.S. courts of appeals to address this issue have held, the contraceptive accommodation process strikes the proper balance between ensuring women have equal access to health care and protecting religious beliefs," that statement read.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.