Workers’ Comp Goes Federal

MaryRose Reaston, founder of Emerge Diagnostics, wrote an article on Insurance Thought today that said the Affordable Care Act (ACA), also known as “Obamacare” will dip into Workers’ Comp.

According to MaryRose, as of Oct. 1, 2016, state Medicaid programs will be able to recover all of the proceeds from a settlement that were expended on behalf of a beneficiary.

Medicaid, she says,  will be able to attach a beneficiary’s third-party liability settlement (including workers’ compensation) for the entire amount of the beneficiary’s award, and not just the amount allocated to medical expenses.

What this means, Reaston adds, is that funds intended to compensate beneficiaries for pain and suffering, lost wages or any damages other than medical expenses could be subject to the reach of state Medicaid agencies seeking recovery.

Many employers will be affected because the adoption of the ACA has afforded broader coverage under state Medicaid programs, MaryRose writes, because it now includes individuals who are within 133% of the federal poverty level (about $32,252.50 for a family of four in 2015), and under 65 years of age.

For the complete article, click on the following link:









6 thoughts on “Workers’ Comp Goes Federal

  1. Dina Padilla

    For far too long employers have shifted their responsibility to public funded programs, thanks to Congress not providing federal.oversight under the 1972 worker compensation Commission. No one not even employers get to shift their responsibilities forever onto the tax payers. I just hope that it is not the injured employee who has to pay out it’s settlement like most applicant attorneys or Worker comp judges allow.


  2. Transforming Workers' Comp Post author

    Dina, there is nothing there about injured workers…not everything is about injured workers…some things relate only to employers because it is the employers who pay for workers’ compensation insurance. This has more to do with the expansion of Medicaid, but Medicaid is not part of workers’ comp, or vice versa.


  3. Dina Padilla

    That’s the other financial crime, out of the forced small settlements after being forced to go to SSDI or SSI, litigation can take years only for the IW to get a pithy WC settlement, certainly most do not see a full total permanent disability when they are unable to work.. Maybe changes will now come when the medical bills from medical funded programs are now involved to get paid back.


  4. Transforming Workers' Comp Post author

    Dina…I support your defense of injured workers, but you are reading too much into this. Sometimes, a cigar is just a cigar, as Sigmund Freud famously said. Sometimes, questions about reimbursements are just questions about how other programs get reimbursed for paying out claims. And since Medicaid does not cover injuries that arise out of and in the course of employment, there is no work comp component. Accept it at face value.


  5. Dina Padilla

    There are some county doctors who will not believe the injured worker about the work injury but will give some treatment or diagnostic testing done and it is sometimes to make it look like the patient isn’t injured at all by a work related injury but none the less, there is some treatment and some diagnosing by the state aid and perhaps, just maybe, to favor the insurer so it doesn’t have to be responsible. As injured workers have told me. The same by PPO’s, HMO’s.etc.


    1. Transforming Workers' Comp Post author

      Dina…read the entire article by MaryRose…she is not talking about injured workers. This is simply the federal government overstepping the line between work comp and Medicaid, which is not aimed at the worker, but could affect his employer.



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