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The Trump administration's bogus claim about Obamacare and workers' comp

One line in a White House news release Monday speaks volumes about either the Trump administration’s understanding of healthcare policy or its tenuous grasp on the truth. Or both.

The release described 11 people who visited President Trump on Monday to talk about the “significant hardship” they’d experienced “as a result of Obamacare’s poor coverage and rising prices.” The hardship, as it turns out, was financial — these were people who were paying a lot more for health insurance than they had in years past.

That’s a real issue, to be sure. But among the complaints levied was this one that the White House made on behalf of a Colorado rancher named Carrie Couey: “[T]he cost for workers’ compensation insurance for her business’ employees increased from approximately $17,000 per year to more than $70,000 per year.”

Ahem. Obamacare, formally known as the 2010 Patient Protection and Affordable Care Act, was utterly silent on workers’ compensation insurance. None of its provisions applied to that specialized market. And to the extent it had an indirect effect on workers’ comp, it helped hold down claims and insurance premiums, according to Joe Paduda of Health Strategy Associates, a former insurance execuwho specializes in workers’ comp issues. Since the ACA was fully implemented in 2014, Paduda wrote, the medical trend rates (the annual increase in claims for medical care) in workers’ comp have been historically low, a “strong indication that [the] ACA is a major factor in lower work comp costs.”

Paduda explained in an interview that about 13 million people who gained coverage through the ACA are workers, many of them in low-wage jobs that had no health benefits. When injured in the past, these people may have been tempted to “claim shift” — to say they were injured while working so they would be covered by their employer’s workers’ comp plan. That need was eliminated when they gained coverage through Medicaid or subsidized private insurance.

Besides, workers’ comp premiums are governed by three factors that have nothing to do with the ACA: how much a company pays its employees, how risky their jobs are and the company’s history of workers’ comp claims. A company’s premiums go up if it gives its workers raises, if they have injuries that cause expensive claims or if other workers in the state who perform similar jobs have a surge in injuries.

You could conceivably make a macroeconomic argument that the ACA is either increasing the cost of medical treatment generally (by encouraging consolidation in the healthcare industry) or decreasing it (by promoting efficiencies and higher quality care). But either way, you’d be stretching credulity to make the connection between the law and workers’ comp.

So, why did the Trump administration blame Obamacare for Couey’s skyrocketing workers’ comp premiums? Perhaps because healthcare is “complicated.” Who knew?

jon.healey@latimes.com

Twitter: @jcahealey

An earlier version of this post described Joe Paduda as a former insurance actuary. He is a former health insurance executive.
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