Tag Archives: Affordable Care Act

ACA Health Insurance Open Enrollment Begins November 1st

Today’s post comes from guest author Kit Case, from Causey Law Firm.

In Washington State, we have a healthcare exchange at www.wahealthplanfinder.org. If this is your first time obtaining health insurance through the WA State exchange, a little preparation and planning will help you through the process.  Gather the documents and information you will need to complete your online application.

Download a checklist of information you will need to apply.

Set aside time to work on your application.  Early morning or late evenings may be less busy and allow faster progress through the application program. Note that the website is down overnight from 10:00 pm to 2:00 am daily.  As you work through the application, save your work.  If you need, you can return to the application to complete it at a later time. 

Quick Tips for Completing the Application.

Workers’ Compensation Benefits are Not Taxable Income. Do NOT over-report your income by including time loss compensation in your in application.  You may qualify for insurance for you and your family at a much lower cost while you are receiving time loss compensation benefits.

Savings are based on your expected household income for the year you want coverage, not last year’s income. The exchange uses an income number called modified adjusted gross income (MAGI) to determine eligibility for savings. It’s not a line on your tax return.

See what’s included in MAGI and how to estimate it.

You can get free, in-person help from a navigator or broker. They can help you fill out the application and enroll in coverage. Search for a navigator or broker by your zip code or language preference. You can also call the Customer Support Center at 1-855-923-4633 for help with the application process.

Photo credit: ccPixs.com via Foter.com / CC BY

Medical Care Politics in Worker’s Compensation

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm.

The mythology surrounding employee fraud in worker’s compensation is pervasive. Many of my clients begin their conversations with me indicating the following: “I’m not one of those folks faking their worker’s compensation claim.”  The exaggerated media publicity concerning employee fraud has also resulted in outright worker intimidation regarding filing a claim. I had this conversation today with a prospective client.

Attorney: Why didn’t you report the incident?
Client: I didn’t want to have that on my record.  Nobody will hire me if I have a worker’s comp injury.
Attorney: Why didn’t you seek medical treatment?
Client: I do not have insurance.
Attorney: Can you obtain insurance under the Affordable Care Act?
Client: You mean Obamacare?  No way!

Fear of being stigmatized as a complainer, whiner, or simply a recipient of worker’s compensation benefits has prompted many legitimately injured workers from filing a worker’s compensation claim.

The adverse publicity concerning the Affordable Care Act (and its pejorative popular name “Obamacare”) results in many otherwise qualified workers from obtaining the health care they need, especially when denied by a worker’s compensation insurance carrier. 

The politics of medical care intrudes in the worker’s compensation arena daily.

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.