Too big to stop? Obama's overhaul lumbers on
Legal Events
Most insurers, hospital executives and state officials expect they'll keep carrying out President Barack Obama's health care overhaul even after a federal judge cast its fate in doubt by declaring all of it unconstitutional.
"It's still the law of the land," said William Hoagland, vice president for public policy at health insurer Cigna. "We'll continue to proceed with its requirements, and (the ruling) will not slow that down. We have no other choice until this thing is resolved one way or the other." Insurers spent millions to block passage of the law.
Health care accounts for about one-sixth of the economy, and many players in the sprawling sector have a love-hate relationship with Obama's health care remake. There's dissatisfaction with key provisions, and a sense that parts may be unworkable. But at the same time, it's seen as a vehicle to start addressing problems of cost and quality that, left to fester, could trigger more drastic consequences.
"I don't think people are going to hit the stop button," said Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research arm of the consulting firm. "You probably don't make the big bets right now, but you make the incremental investments in case you have to make the big bets 6 or 12 or 18 months down the road. Everyone proceeds with an informed approach."
Monday's ruling by U.S. District Judge Roger Vinson in Florida had been expected to go against the Obama administration. But the scope of the decision in a lawsuit by 26 of the 50 states took some by surprise.
Vinson struck down the entire law after finding its requirement for nearly all Americans to carry health insurance unconstitutional. Another judge who reached the same conclusion in a separate case voided the individual insurance requirement and left everything else in place.
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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.