Paduda: Health Insurance Status and Workers' Comp

Wednesday, June 6, 2018 | 0

The headlines were comforting: Not much change in the number of Americans without health insurance.

Joe Paduda

Before you breathe that sigh of relief, you’d be well-advised to dig a bit deeper, because there’s plenty of bad news just under the headline.

While the national number of uninsured stayed about the same, that’s irrelevant to you — because health care is local. Here’s what I’d be worried about:

• Young adults are almost twice as likely as older adults to be uninsured. About one in six younger adults don’t have coverage. No health insurance = more incentive to file work comp claims.
• Over a quarter of working-age Texans don’t have coverage. Georgia, Florida and North Carolina are not far behind. No health insurance = poorer health status, more comorbidities and more charity care for providers, thus more incentive to cost- and claim-shift.
• Forty-four percent of working-age adults were covered by high-deductible plans, but more than half of them don’t have health savings accounts needed to fund the high deductibles. “High” deductible health plans aren’t much different than no insurance at all if the patient can’t afford the deductible, and more than half can’t. So, more incentive to cost- and claim-shift.

What does this mean for you?

Workers’ comp will be affected by the Trump administration’s ongoing behind-the-scenes effort to hollow out the Affordable Care Act, and cut funding for Medicare and Medicaid.

Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers. This column is republished with his permission from his Managed Care Matters blog.