The Problems with States Refusing Medicaid Expansion

Today’s post comes from guest author Brody Ockander, from Rehm, Bennett & Moore.

Medicaid expansion was a large part of the recent health care reform law under the Affordable Care Act. For reasons that seem to be solely based on politics, some state governors have made public their decision to reject the Medicaid expansion, and as a result, federal funding of the expansion.

Besides the obvious problems this rejection would cause for millions of uninsured Americans and the health care providers who treat these uninsured people, this rejection could have a negative effect on workers, especially injured workers, of these states.

Fellow workers’ compensation lawyer, friend and colleague Tom Domer of Wisconsin discussed the possible ramifications when an injured worker does not have access to health insurance. Mr. Domer discussed the following scenario that we see day in, and day out, in a previous blog post:

“The personal toll on the uninsured is devastating, especially for those dealing with work injuries.

As a worker’s compensation attorney, the following scenario plays out on a daily basis: A hard-working individual—who is lucky enough to have health insurance through the employer—is injured at work through no fault of his own. The injury is severe enough to not allow a return to work, or the employer simply terminates the employee (this insidious action happens far too often with far too little publicity). After termination, the injured worker is offered federal COBRA rights to continue paying the health insurance premiums at the full 100%, which of course, is near impossible when you are off work without income. Thus, the worker loses health insurance for himself and for his family.

On the flip side, the worker’s compensation insurance company is supposed to pay for reasonable medical treatment expenses related to the injury; however, the carrier usually hires an “independent” medical doctor to deny the worker’s compensation claim. The injured worker is then left out in the cold with an injury that requires medical treatment, but he has no ability to get that medical treatment without health insurance or workers’ compensation coverage. The worker then calls me and asks the emotionally-laden question: ‘What do I do?’”

Nebraska is one of the states that is “Leaning Toward Not Participating” in the Medicaid expansion, at least according to Gov. Dave Heineman’s public statements on the topic.

This can have a devastating effect on Nebraska workers who have suffered an injury.

As Mr. Domer further states:

“Access to health insurance alters this equation. If the worker had adequate access to health insurance, especially Medicaid, he could obtain the medical care that could allow a return to work, regardless of whether the worker’s compensation insurer accepted or denied the claim. Whether work-related or not, injured individuals should have the opportunity to get healthy in our country.”

So what can be done about this problem? Contact your government officials to encourage them to provide injured workers increased access by expanding Medicaid.