Failure to Expand Medicaid Could Lead to Cost-Shift to Work Comp

Joe Paduda wrote this morning on his blog about the failure to expand Medicaid in several states, and its impact on workers’ comp.

This is not the first time Joe has written about the reluctance of politicians in states like my current state of Florida, Texas, Virginia, Wisconsin and others.

As Joe rightly has pointed out in each of his articles, the government is paying for all of the additional cost for another two plus years, and the vast majority of the cost thereafter; and the savings to the states for uncompensated care will be anywhere from $4 to $9 billion.

Health care providers in non-expansion states are in dire straits due in large part to the “non-expansion”, according to Joe.

With regard to my current state of Florida, our walking male appendage of a governor (who stole millions when CEO of HCA), is not only suing the federal government for money, but just returned from Washington empty-handed.

According to an article in today’s Palm Beach Post, Gov. Rick (rhymes with D***) Scott, traveled Wednesday to Washington to meet with U.S. Health and Human Services Secretary Sylvia Burwell, who he sued last week.

Scott alleges that the Obama administration is attempting to coerce Florida into expanding Medicaid or face losing $1.5 billion in funding for hospitals and other health providers treating uninsured patients. The governor is demanding that Florida continue collecting that money without expanding Medicaid.

Typical Rick Scott.

After the meeting, HHS reiterated its view that these so-called low income pool dollars are an “optional, time-limited demonstration program” that won’t be continued in its current form. And the agency also made the case for Medicaid expansion as a way for hospitals to cover the cost of uncompensated care.

As reported in the Post, Scott exited the meeting Wednesday saying that the state is in a “time crunch” and needs a quick answer from HHS, with the state budget in limbo.

As far as Joe sees it, there are a host of problems with the position Scott and other GOP governors are taking. These problems are due to two things, Joe says.

In the short term, the cost pressure placed on facilities and health systems and the fallout therefrom to will lead to increased pressure to cost shift to work comp.

Long term, the 6.4 million adults who remain uninsured will be less healthy, will have more incentive to get care under workers’ comp, and will heal more slowly with more complications if they do get injured on the job, according to Joe.

It is Joe’s contention, however, that the states will expand Medicaid, because the financial pressure will force them to.

So what does this mean for worker’ comp and medical travel?

It will mean that there will need to be an alternative to the current system of providing medical care to injured workers in the event that these states never expand Medicaid, or at some future date after doing so, and the citizens of those states balk at the expense of paying for health care for poor people.

My last post dealt with lowering litigation costs and experience modification factors, which is used to determine the premiums employers are charged for workers’ compensation policies.

If you consider the cost-shifting to work comp that Joe mentions, and the shortage of physicians predicted to impact all of health care, and many other challenges and problems workers’ comp will face in the coming years, then it is imperative that workers’ comp look for a way to alleviate the pressure that cost-shifting, physician shortages and other challenges Joe, David De Paolo, myself, and others have been writing about.

The conversations I had earlier this week gave me the confidence to say that such an alternative already exists and will become a reality all across the US. It is only a matter of time.

The choice is yours. Do nothing and reap the consequences, or do something about it now, before the you-know-what hits the fan.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: Share this article, or leave a comment below.

This entry was posted in Cost Shifiting, Health Care Costs, Hospitals, Medicaid Expansion, Medical Tourism, Workers' Comp, Workers' Compensation and tagged , , , , , , , on by .

About Transforming Workers' Comp

Have worked in the Insurance and Risk Management industry for more than thirty years in New York, Florida and Texas in the Claims and Risk Management spheres, primarily in Workers’ Compensation Claims, Auto No-Fault and Property & Casualty Claims Administration and Claims Management. Have experience in Risk and Insurance Business Analysis, Risk Management Information Systems, and Insurance Data Processing and Data Management. Received my Master’s in Health Administration (MHA) degree from Florida Atlantic University in Boca Raton, Florida in December 2011. Received my Master of Arts (MA) degree in American History from New York University, and received my Bachelor of Arts (BA) degree in Liberal Arts (Political Science/History/Social Sciences) from SUNY Brockport. I have studied World History, Global Politics, and have a strong interest in the future of human civilization in all aspects; economic, political and social. I am looking for new opportunities that will utilize my previous experience and MHA degree. I am available for speaking engagements and am willing to travel. LinkedIn Profile: Resume:

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