Does Increased Access to Health Insurance Impact Claims for Workers' Compensation?

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Although workers’ compensation programs insure people against on-the-job illnesses and injuries whether or not they have health insurance, new Upjohn Institute research finds that increasing the number of people with insurance can drive down workers’ compensation costs.

The 2006 Massachusetts health care reform, which served as a model for the national Patient Protection and Affordable Care Act, led to a 50 percent drop in that state’s uninsured rate. Erin Todd Bronchetti and Melissa P. McInerney find that the increased access to health insurance brought on by the reform reduced the per-capita number of emergency room visits billed to workers’ compensation by 6 to 8 percent.

At the same time, total emergency room visits per capita dropped by a similar amount, say Bronchetti and McInerney, suggesting that people were receiving care elsewhere instead of just switching payers for emergency room care. Because more people had health insurance, they could seek help at a doctor’s office or urgent-care clinic instead.

While Massachusetts’s workers’ compensation program enjoyed a drop in emergency room billings following health reform, there’s a bigger benefit than merely shifting costs from one payer to another. When people seek treatment at a doctor’s office or clinic, the cost of a given procedure is also usually lower than at an emergency room.

The research was funded by an Upjohn Institute Early Career Research Award and expands on research from Marcus Dillender’s 2015 paper “The Effect of Health Insurance on Workers’ Compensation Filing: Evidence from the Affordable Care Act’s Age-Based Threshold for Dependent Coverage.”

Download Bronchetti and McInerney’s paper: “Does Increased Access to Health Insurance Impact Claims for Workers’ Compensation? Evidence from Health Care Reform.”