PHILADELPHIA—There is little question that the PatientProtection and Affordable Care Act (PPACA) will impact everyAmerican, but its ramifications on Workers' Compensation remains asubject of conjecture and speculation among legal experts and riskmanagers.

“It is so fluid a situation that we have to say to our clientsthat we don't have the answer; no one does,” says Catherine J.Flynn, an attorney at Weber, Gallagher, Simpson, Stapleton, Fires& Newby at an educational session April 11 during the PhillyI-Day conference.

Holding up the 1,000-plus pages of the PPACA, Flynn says onlyeight pages directly relate to Workers Comp, but the rest of thelaw could have much greater implications for that line ofcoverage.

The focus on wellness and preventive care could have long-termimpact on costs as workers become healthier and get in front ofchronic diseases. This would not only drive down healthcare costs,but could have positive results for Workers' Comp costs.

Christian Davis, also an attorney with Weber Gallagher, says adownside to the preventive and wellness programs is that sincepeople are exercising more, they may come to work and say they wereinjured on the job to put in a claim. However, the law might havethe opposite effect—since if they have insurance they would be morewilling to see a doctor for an examination.

That would also affect the number of fraud and abuse cases inthe Workers' Comp program because they would have a healthcareprovider to go to and not need to rely on Workers' Comp to cover anaccident or illness, Davis suggests.

One impact costs is the more than 2 percent tax on medicaldevices that took effect this year, says Davis. The tax aims toraise $20 billion over 10 years to help pay for parts of PPACAprogram. Insurers could see those costs passed on to them, shesays.

With more people coming into the healthcare system because theyhave insurance, there is a fear there will be a shortage ofdoctors. Ben Evans, executive director of risk management for theUniversity of Pennsylvania, says, as a self-insured program, it isalready difficult to contract with physicians to cover Workers'Comp cases. A physician shortage would not only make the situationmore tenuous, but also drive up costs.

The physician shortage would make it more difficult for patientsto get treatment, meaning individuals may be out of work longer,says Evans. However, Anita Devan, senior vice president andregional executive for Zenith Insurance, points out that PPACA doesprovide funds to medical schools for developing family practicephysicians, aimed at increasing the pool of doctors.

On the positive side, says Evans, a wellness program would helpreduce accidents and improve overall health, which would decreasecosts, he hopes.

From the standpoint of a risk manager, self-insured programslike to control what they can. He says he worries that PPACA willmake it more difficult to have that control.

“We do not know what this [PPACA] means,” says Evans. “We workhard at the University of Pennsylvania to drive costs and do thebest we can to get people back to work.”