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Will recent Affordable Care Act court rulings impact workers’ compensation?


When the Affordable Care Act (ACA), courts and differing points of view are all mentioned in the same sentence it should not surprise anyone, should it? If you watch Jimmy Fallon on the Tonight Show, he has a regular feature called "Pros and Cons" of current social topics. Let’s take our own pro/con look at recent movement in the courts and what – if any – impact it might have on the workers’ compensation arena.


A three-judge panel of the U.S. Circuit Court of Appeals for the District of Columbia ruled that the Affordable Care Act does not allow subsidies on federally run exchanges. This includes plans that have been purchased in the 36 states currently supporting the health insurance exchange.


The same day (and hours apart), the U.S. Court of Appeals circuit in Richmond, Va., issued a conflicting ruling that upheld the legality of the healthcare law's tax subsidies.

What should I do now?

Nothing. Right now there is no impact or change to the law and the ACA will continue to roll along as it is currently defined. In April of this year, I blogged on "The impact of the ACA on workers’ compensation," and you can refer back to better understand the interconnection of workers’ compensation and the Affordable Care Act. The reality – these are just two of what will be many more court cases and rulings to come in weeks and months ahead of us. I feel fairly certain, as do other experts who have already written in recent days, that this will ultimately end up in the Supreme Court.

You can count on Supreme Court action not happening for a few months and most likely we are looking at years before a possible definitive Supreme Court case is fought. A new administration and a different-looking congressional body will also be in place by that time. As pointed out in this Washington Post article, Federal appeals courts issue contradictory rulings on health-law subsidies, the court rulings were heavily influenced by appointed judges of each party. The article provides a great overview of how the courts are aligned and strategies for appeal if you are interested in additional perspective.

Keep calm and carry on.

As the popular shirts and posters say, "keep calm and carry on" for now. The way patients are treated and their access to care will not change or stop in light of either of these two rulings. What we must do in the industry is help the injured worker become more engaged and part of their healthcare decisions as the legal decisions continue to rage on and unfold.

What I can definitively say is we will continue to closely monitor all these changes. The future will not be boring nor easy to navigate. Please feel free to ask questions or reach out on how your organization should be preparing for the future of the ACA as it relates to workers’ compensation.

Kimberly George, SVP, Senior Healthcare Advisor

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