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ACA Repeal Could Lead To More Workers Comp Case Shifting


Will ACA Repeal (Affordable Care Act) Cause Case Shifting to WC?

The drumbeat for ACA repeal  has grown much louder with the new administration just around the corner.   This article on the new demands to keep Obamacare alive was an interesting angle from the health insurance sector.

Obamacare ACA Repeal Logo
Wikimedia Commons – Obama

Please read the article for all the information.  The two main conditions were to:

  • Allow the subsidies for low-income insureds
  • A three-year unwinding – not an immediate cessation

In  2015, Dr. Richard Victor – then CEO of WCRI, presented the concept of case shifting from health to workers comp due to the lack of sufficient health insurance markets and other conditions.

After reading the above-linked article, one would have to say that if there is a sudden shift in the health insurance marketplace from the government abolishing the ACA?

One of the stark recommendations in the article was the penalty was too small to cause the younger employees to seek out and buy ACA policies.   This scenario seems ripe for case shifting to WC.

Would Workers Comp actually become a bastion for the failing health care market?

Please follow the links to the prior article on Dr. Victor’s predictions.  I had thought the concept was professorial and not real-world when I had first written about it.    Possibly, I was the one that was eccentric to think this would never happen.

This would not be difficult to study unless more variables are in place that will affect WC over the next decade or two.   We shall see.

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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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