The ACA and Your Personal Injury Case

The Affordable Care Act (ACA) or “Obamacare” became law in 2010. It requires virtually all Americans to maintain some form of health insurance. This much debated law has resulted in changes in personal injury cases in New Hampshire and throughout the United States.

Medical Bankruptcy Affordable Care Act and Personal Injury

When an injured individual is projected to have long-term and even lifelong medical expenses, their doctor or life care planner prepares a life care plan. This plan details the treatments that are likely to be required for future care of their injuries. These plans currently do not take into account medical insurance when computing the costs of future treatment.

We know that the Affordable Care Act means that virtually everyone is required to be covered by medical insurance. This means that life care plans are likely to be attacked and devalued by defendants and insurers as they demand to recalculate the values based upon the medical insurance coverage of the plaintiff.

The Collateral Source Rule in New Hampshire prevents introduction of evidence of health insurance coverage when considering the amount of medical damages. This means that if you require a $5,000 surgery for your injuries, but your insurance provider covers 80 percent of that cost, you will still receive credit for the full $5,000 when your damages are considered. It essentially prevents individuals from essentially being penalized for carrying health insurance. The traditional rationale for this rule as applied to health insurance was that we wanted to reward and not punish those who chose to have health insurance.  Now that individuals are required to carry insurance under the Affordable Care Act that rationale may be challenged and if these challenges dissolve the Collateral Source Rule it could negatively impact personal injury awards and settlements.

Uninsured parties may actually benefit, in part, from the Affordable Care Act. Prior to passage of the ACA, uninsured parties were often charged an overinflated rate for medical procedures. This rate was often much higher than that charged to insurance companies. This means that uninsured parties paid a much higher amount to hospitals to settle unpaid bills when their cases settled and therefore were left with a smaller settlement. The ACA requires that hospitals eliminate the overinflated “list price” they had been charging to uninsured parties and instead charge them similarly to insurance companies. Although this means that a smaller percentage of the settlement received will go to the hospital for medical payments, it also means that overall damages and recovery are likely to be less.

The complete impact of the ACA on personal injury law remains to be seen, but early indicators show that settlements will be lower if medical insurance is taken into consideration. Achieving a strong and fair settlement for your injuries may be more difficult than ever. Call upon the experience team at McGohey Law either online or at 603-657-7157.  As always, we put you in control of your case!


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