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Affordable Care Act (Obamacare) Effects on WC – LIVE WCRI


Affordable Care Act – Effect on Workers Comp- LIVE

The Effect of Th Affordable Care Act(Obamacare) on WC could be significant.

Dr. Richard Victor-  (Will update during presentation until finished) – not edited until final version

Picture of Affordable Care Act Doctor and Patient Shaking Hands

The effects of ACA on WC are: (could be):

  • Increased demand for medical care
  • Shortage of providers – when demand exceeds supply
  • Possible increased prices- basic market function when supply stays same and demand increases – remember the gas lines in the 1970’s?
  • How will WC system adjust to ACA?  – use of Nurse Practitioners , Physician Assistants, Pharmacists, Podiatrists
  • States that will be affected more are ones that have opted-in for the Medicaid expansion
  • States may have to increase the appeal of their medical markets to recruit and maintain medical providers
  • Workers Comp overall pays more than health providers, especially Medicaid/Medicare

29% of all patients in Canada have to wait for even basic medical care

Workers Compensation has the indemnity benefit that will be lengthened – Will WC carriers pay more than fee schedule to reduce the indemnity benefits?

Surprisingly, there are many states where WC actually pays less than Medicaid/Medicare benfits – which may be the states where there could be a shortage of  medical providers unless there is an increase in the fee schedule rates.

Patient Affordable Care Act Talking To Doctor

Contrast – Minnesota vs. Florida  medical environment

Oregon Study –  30,000 people added to Oregon Medicaid program

  • Diabetes diagnosis was statistically significant
  • Cholesterol diagnosis was not significant
  • Depression was identified enough to be statistically significant
  • Bottom line – increasing medical coverage increases public health

States that have longer term use of opioids – Louisiana was #1 for long tern opioid use.   Arkansas had highest surgical rates of any state.

Cost shifting –  higher prices to WC as part of a shift in the general medical marketplace

Hospital mergers showed little statistical significance as they relate to increases in prices

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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