Workers’ Compensation and “Medicare for All”
At the 2019 NCSI Annual Meeting, Doug Holmes from Strategic Services on Unemployment & Workers’ Compensation (UWC) talked about how workers’ compensation factors into the “Medicare for All” push.
Is “Medicare for All” a serious possibility? It does poll well with the public and it is a focus of the Democratic Party including all of their Presidential candidates. So yes, this is an issue that needs to be taken seriously.
There are two “Medicare for All” bills in Congress right now. S 1129 was introduced in April by Bernie Sanders. The bill states that “no employee benefit plan may provide benefits that duplicate payments…..which may be made under the universal Medicare program.” The bill prohibits private help insurers and self insured ERISA plans for group health.
The question becomes, where does workers’ compensation fit into this? Workers’ compensation is not something that can be paid currently under employee health programs or Medicare. The bill does say workers’ compensation must reimburse Medicare for payments they make which should have been covered under workers’ compensation. This sounds similar to the current Medicare Secondary Payer statutes.
The “Medicare for All” bill also prohibits the use of a social security number as an identifier on the Medicare card. That leads to the question of how you could ever track payments that should have been covered under workers’ compensation. There are lots of unanswered questions in this bill including how it would be paid for.
What is realistic to expect in 2020? This all depends on what happens in the election. If Republicans still control the Senate or the Presidency, then this will not move forward. However if Democrats were to take control of everything they would try to push this forward even with all the unanswered questions about how it would work and be paid for. The thought it it would initially be an expansion of Medicare coverage rather than full-blown Medicare for All.
The Sanders bill is unlikely to move forward in the Senate, but there is a House bill that could move forward. HR 1384 has been heard by the rules committee and could be moved to the House floor for debate at any time. This bill has not been scored by the Congressional Budget Office yet. Unless the supporters of this legislation can figure out how to pay for it, the CBO will be a big obstacle.