Five Ways ObamaCare Could be ObamaComp(c)
The five ways Obamacare and Workers Comp are similar may come as a shocker. The Wall Street Journal very recently published an article on how the Affordable Care Act will affect health insurance premiums. There seemed to be a few items in the Act that sounded very similar to Workers Comp.
The first similar component is health insurance costs and Workers Comp medical treatment fees both being indexed or based on the Medicare/Medicaid fee schedules. A large majority of states now use fee schedules to reimburse providers for medical treatment.
The second similarity is in states with no fee schedules, the Usual and Customary charges are indexed on a Zip Code or address. The Usual and Customary charges seemed to be very similar to the community-based pricing requirements of the Affordable Care Act.
The final three comparisons are best compared by an excerpt from the article. The following three components reminded me of the same Workers Compensation insurance requirements.
Central to ObamaCare are requirements that health insurers
- Accept everyone who applies (guaranteed issue)
- Cannot charge more based on serious medical conditions (modified community rating)
- Include numerous coverage mandates that force insurance to pay for many often uncovered medical conditions.
Workers Comp insurers have almost the same requirements:
- Accept everyone that applies indirectly as all employees are covered. Workers Compensation insurance is a guaranteed issue policy of sorts
- Cannot charge more for employees with serious pre-existing conditions. Workers Comp insurers cover the employees regardless of prior medical condition
- Are sometimes forced to cover injuries that may have not been work-related
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