Judge’s ruling on ‘Obamacare’ poses new problems for GOP
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A federal judge’s ruling that the Obama health law is unconstitutional has landed like a stink bomb among Republicans, who’ve seen the politics of health care flip as Americans increasingly value the overhaul’s core parts, including protections for pre-existing medical conditions and Medicaid for more low-income people.
While the decision by the Republican-appointed judge in Texas was sweeping, it has little immediate practical impact because the Affordable Care Act remains in place while the legal battle continues, possibly to the Supreme Court.
HealthCare.gov , the government’s site for signing up, was taking applications Saturday, the deadline in most states for enrolling for coverage next year, and those benefits will take effect as scheduled Jan. 1. Medicaid expansion will proceed in Virginia, one of the latest states to accept that option. Employers will still be required to cover the young adult children of workers, and Medicare recipients will still get discounted prescription drugs.
But Republicans, still stinging from their loss of the House in the midterm elections, are facing a fresh political quandary after U.S. District Judge Reed O’Connor said the entire 2010 health law was invalid.
Warnings about the Texas lawsuit were part of the political narrative behind Democrats’ electoral gains. Health care was the top issue for about one-fourth of voters in the November election, ahead of immigration and jobs and the economy, according to VoteCast, a nationwide survey for The Associated Press. Those most concerned with health care supported Democrats overwhelmingly.
In his ruling, O’Connor reasoned that the body of the law could not be surgically separated from its now-meaningless requirement for people to have health insurance.
“On the assumption that the Supreme Court upholds, we will get great, great health care for our people,” President Donald Trump told reporters during a visit Saturday to Arlington National Cemetery. “We’ll have to sit down with the Democrats to do it, but I’m sure they want to do it also.”
Economist Gail Wilensky, who oversaw the Medicare program for President George H.W. Bush, said the state attorneys general from GOP strongholds who filed the lawsuit really weren’t very considerate of their fellow Republicans.
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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.