The Democrats winning control of the U.S. House of Representatives and of governorships and legislatures in multiple states in elections last week could result in improvements in health care access at the federal level and the passage of bills at the state level that could boost comp benefits for injured workers.
“My initial reaction was to look at the states where there are new trifectas — where one party now controls (all three governing bodies),” said Mark Walls, Chicago-based vice president of communication and strategic analysis for Safety National, who is also part of the company’s government affairs team. “That’s where (we are) most likely to see something done.”
The six states where Democrats now control the governor’s seat and both the state house and the senate include Colorado, Illinois, Maine, New Mexico, Nevada and New York, according to an analysis by Cari Miller, Rolling Meadows, Illinois-based director and counsel for governmental affairs at Gallagher Bassett Services Inc.
Illinois is of particular interest, she said, as lawmakers in that mostly-Democratic state have attempted to introduce worker-friendly workers compensation reforms over the past two years, only to have those attempts vetoed by current Republican Gov. Bruce Rauner. Gov.-elect J.B. Pritzker, a Democrat, once chided Gov. Rauner for vetoing a comp bill in media interviews but has not released a plan to act on comp reform himself.
“It will be really interesting with (Gov.) Rauner trying to be more business friendly and veto what the Democratic legislature was trying to do,” she said, adding that some examples of reform included increased payments for workers and changes to the fee schedule for treatment.
“There is now going to be a lot more employee-favorable changes,” Ms. Miller said.
New York is another state to watch, according to Mr. Walls, referring to recent data that pegged New York as having the highest comp costs.
“Usually something like that would make the legislature look at cost drivers, but with Democrats in control I’d be surprised if something happens there” in terms of reform, Mr. Walls said. New York is also noted as having the highest indemnity payments for injured workers countrywide.
That governors in most states appoint workers compensation commissioners and judges is another factor that could cause a shift for injured workers, experts said.
“That could be a change in the lay of the land in the courts,” said Mr. Walls.
On the national front, with Democrats now a 227-strong majority in the house, experts say changes to health care such as further revamping the Affordable Care Act or reintroducing elements of health care reform that were chopped would likely affect access to care, which would have a trickle-down effect for comp.
For example, there may be a tendency to attribute an injury to a workplace accident in cases when a person does not have access to health care through a traditional health care insurance plan, said Brian Allen, Salt Lake City-based vice president of government affairs for Mitchell International Inc., a technology firm that manages pharmacy transactions, among other tasks in workers comp.
“Adequate access outside of comp is important,” he said.
The expansion of Medicaid is another party promise and place to watch, according to Ms. Miller.
“If Medicaid (subscribers) rise and more people have access to health care, it will affect comp because if more people have more access to health care frequency will level out,” she said.
Two potential changes to medical care offerings across the board are likely to further affect workers comp: drug pricing and telemedicine, according to experts.
“The drug conversation will be positive, and it may move the needle finally” on pharmaceutical costs, said Mr. Allen. Such changes have garnered bipartisan support in the past, and with recent “cost increases that seem inexplicable,” even in the realm of generic drugs, that could push lawmakers to act, he added.
Expanding Medicare offerings for older Americans in the telemedicine space is another change likely on the forefront, according to Mr. Allen. Such a move would affect workers compensation, as any expansion into health care conducted over the phone or internet will likely expand into treating injured workers, he said.
Another plus for injured workers could be that the federal government could zero-in on what some Democrats nationwide have seen as an “erosion of benefits” under state systems, said Mr. Allen.
Lawmakers at the federal level “could initiate some efforts of discovery as far as figuring out what is happening in the comp space and are we adequately handling comp claims,” Mr. Allen said.
Prompting the conversation could be the latest news that workers comp rates for employers have declined across the states, some to the tune of double-digit decreases, according to experts anticipating more worker-friendly measures across the country.
“In certain states, with rates being down like they are, I wouldn’t be surprised to see a push to increase benefits,” said Mr. Walls. “The conversation I see is rates are down, employers are benefitting. There’s the argument that they could pay more to improve coverages for employees.”
This article was first published by Business Insurance.