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Congress Allows Sick Leave Benefits To Expire This Month

Obamacare once helped tens of millions more Americans acquire health insurance, setting the stage for the rate of increasing healthcare costs to slowly diminish over a period of decades. That promise proved difficult for many Americans to understand, which is why Trump promised his supporters he would gut Obamacare at the earliest opportunity. Although he has mostly failed in that venture, Trump managed to remove the individual mandate from the Affordable Care Act, allowing people to opt out without incurring a steep penalty come tax season. That meant millions more Americans decided it made more sense to go without health insurance instead of incurring the penalty.

The consequences of these decisions have been felt this year because of the coronavirus pandemic raging across the globe — which is only getting worse during winter — almost as if it was a sign from the heavens for us to wake up and do what is right by our people.

Earlier this year, Congress eased the financial suffering of some of these millions by guaranteeing employees the right to two week of sick leave should they be diagnosed with COVID-19. They had the option to renew this part of the stimulus — which is set to expire at the end of December — but Republicans have blocked the measure lockstep, which protected 87 million Americans. In addition, the amount of stimulus money that will be provided to everyday Americans is only half of what they received earlier this year: $600.

Republican Senator Lamar Alexander said, “This is no time to impose an expensive new mandate or unexpected new costs when they don’t have the money coming in to pay for the normal costs. So I’m afraid, as a result of this, many employers worried about this provision may have an incentive to lay off more of their employees.”

Thankfully, the new bill will still provide incentives to those who continue to provide paid leave in the form of refundable tax credits. But that might not be enough to help those without affordable insurance.

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Could A Conservative-Dominated Supreme Court Destroy Health Insurance For Millions?

This question has been propelled to the top of the list ever since Trump and McConnell fought to ram through a new Supreme Court nominee weeks ago: Will a 6-3 conservative-led Supreme Court fight to abolish the Affordable Care Act (ACA)? Depending on whether or not you support Obamacare, you might not like the answer. Truth be told, the ACA has been attacked for years, and many GOP government officials have made their distaste for the law very well known.

The moment that Trump made his nomination of Barrett, healthcare stocks began to react volatilely. 

Jefferies health care analyst Brian Tanquilut had warned: “It sounds like the Republicans are really gonna push for a Supreme Court nominee approval before the new administration (and) the fear is that the ACA will be probably repealed. I’m not sure that’s necessarily the case, but obviously that’s the fear that’s been baked into the stocks right now.”

Regardless of the outcome of the election, things were never going to get less uncertain than they are right now. There is a small amount of good news. During Obama’s time in office, the GOP members of the Senate made dozens of votes to repeal and replace Obamacare knowing they didn’t have enough votes to get anything done), but once Trump made it into office, and they might have been able to make waves, they stopped holding votes. In other words, it might all have been for show in order to retain the appeal of their constituents.

Unfortunately, that doesn’t mean a conservative-led Supreme Court won’t do what a conservative-led Senate wasn’t willing to do themselves. But Professor Nicholas Bagley of the University of Michigan Law School acknowledges that the balance of power is shifting so much that no one really knows what will happen.

He said, “If the case gets argued in front of a new Supreme Court with a new justice, the center of gravity and the court will no longer be with Chief Justice Roberts, who has turned away too much stronger challenges to the law. It’ll be with the other conservative justices.” 

Democrats need to start winning over “purple” states like Texas if they want to cement their chances of winning state, local, and federal elections over the long-term — as doing so is the only way to ensure that civil rights and well-liked healthcare programs (like the ACA) stay in place for years to come. Even should Democrats continue winning elections, though, the Supreme Court is still lopsided in favor of conservative voices, which means that the ACA remains in a state of constant peril for years to come.

Texas Senator John Cornyn made his opposition to the ACA clear weeks ago during a press conference at City Hall in Dallas, even though he admitted that he favored coverage based on preexisting conditions. To keep the ACA safe, officials like him need to continue to be kept away from higher office.

A ruling five years ago upheld many core tenets of the ACA:

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What Would Happen To Insurance Rates If Obamacare Is Overturned?

The death of Ruth Bader Ginsberg means that new Supreme Court nominee Amy Coney Barrett will likely be seated before Election Day, providing the highest authority in the land with an overwhelmingly conservative 6-3 advantage — providing Republicans with the ability to overturn important historical benchmarks in our country such as marriage equality, Roe v. Wade, or even the Affordable Care Act (ACA).

This is why Democrats are in such an uproar. Majority Leader Mitch McConnell (Republican, Kentucky) said that the GOP has no expectation that the new Supreme Court will overturn the ACA — even though their Republican commander-in-chief is leading the charge to repeal the ACA through legal action expected to reach the Supreme Court. They say they want to “repeal and replace,” which is a talking point they’ve used for years and years — even without putting forth an actual replacement.

Should the ACA be repealed, it is expected that nearly 30 million people will lose their insurance. Also attached to the law are stipulations that all insurers, both public and private, are required to provide insurance to those with preexisting conditions. The repeal of the ACA means that insurers can remove those with preexisting conditions from their plans. Over a million people would also lose their jobs as less money is spent by consumers who would need to decide between insurance and other basic necessities like food or rent.

Insurance companies would also be able to take insurance away from countless 20-somethings, who under the ACA can stay on their parents’ plants until age 26. 

Because of these added benefits, insurance rates went up after the law was implemented — but most of the rate of growth was already expected by industry analysts looking at skyrocketing costs over the years. If the ACA goes away, a temporary lull in rising costs could be expected — but only at the cost of the benefits it provided.

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Do Employers Have Insurance For Sexual Harassment And Sexual Assault?

Thanks in part to the ever-present #MeToo movement, the number of public cases against high-profile defendants accused of sexual harassment or sexual assault has grown exponentially over the past few years. Perhaps this is why we have received so many inquiries from readers who want to know whether or not large companies and corporations can buy insurance to protect themselves from the unwanted sexual advancements of their employees.

The answer is yes.

This will leave a foul taste in some people’s mouths, but for anything that can affect a business’s profits there is an insurance clause to cover it. There are a few different types of insurance that covers claims for sexual harassment or assault, such as an employment practices liability insurance policy (EPLI). Another possible avenue of protection is basic liability policy for directors and officers (D&O).

Not every claim will result in compensation — because the facts matter. Allegations of harassment or assault must meet the definitions provided by the Equal Employment Opportunity Commission (EEOC). According to this definition, sexual harassment is indicative of “unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when this conduct explicitly or implicitly affects an individual’s employment, unreasonable interferes with an individual’s work performance, or creates an intimidating, hostile, or offensive work environment.”

We should make a few aspects of such a case clear based on this definition. First, the harassment or assault must be proved by factual evidence. Mere allegations are not enough. 

Vice President Marie-France Gelot of Lockton Northeast wrote, “Whether or not a claimant is able to actually make a case proving that sexual harassment occurred, the reality is that the bulk of liability faced by companies accused of such conduct is not generated after a jury trial. It is generated by attorneys’ fees in litigation, win or lose. In the current environment, this is a critical point; any perceived harassment can result in six-figure liability for a company, regardless of whether a judge or jury would ultimately find the harassment unlawful.”

That means that companies still pick up insurance simply based on the fact that a mere allegation can cost many hundreds of thousands of dollars — even if actual evidence of misconduct does not exist. This is in part due to the fact that any lawsuit will likely involve attorney’s fees for the other side, and a sexual abuse attorney can be pricey for a victim. 

Those seeking insurance — or those seeking damages for sexual harassment or assault — should remain keenly aware that the national conversation on this type of abuse is ongoing and that rapid-fire changes to laws in jurisdictions around the country and the world remain constant. That means that insurance adjusters are more likely than not to continue adjusting policies to reduce the possibility of collection from either side (because insurance only works properly if insurance companies cover aspects of everyday life that don’t often result in a good case). 

Gelot confirmed as much when she said, “It remains to be seen if EPLI insurers will react to the momentous changes occurring in the national conversation on sexual harassment in the workplace by limiting the scope of the coverage or making it more expensive.”

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Insurance Rates Poised To Skyrocket In 2021

New York-based insurance companies wish in hike premium rates on average of 11.7 percent for the 2021 year. Why? Because they say costs are growing due to the coronavirus outbreak. These projections were made public by the Department of Financial Services recently. Government authorities have yet to make a public comment to address growing concerns about already skyrocketing costs, especially since an increasing number of residents are uninsured after losing jobs.

One Manhattan-based insurer wants to increase rates a whopping 19 percent.

Shockingly, the rate hikes were called “reasonable and fair” by the New York Health Plan Association. According to the group, rate hikes would correspond to rising health care costs, most of which were do to COVID-19, a disease which has already resulted in 24,000 NY fatalities — nearly the number of deaths in a typical flu season, nation-wide. 

NYHPA President Eric Linzer said, “From the outset and throughout the continuing coronavirus crisis, New York’s health plans have made extraordinary efforts to meet the needs of consumers, businesses and our health care partners. This has included waiving copayments and cost sharing for COVID-19 testing, telehealth services and mental health services for essential workers, and providing cash advances and other support to hospitals, physician practices and others in the delivery system to address the financial uncertainty they’re facing.”

Nothing, as they say, comes free. The services recently offered without cost are the basis for most of the expected rate hikes in 2021. In 2019, eight companies with a public IPO made over $21 billion — which constituted a massive 31 percent increase in profit over the previous year. Basically, no one should believe that these companies actually need to increase their rates.

Do you believe you were taken advantage of by a health care company during the coronavirus crisis? Did you lose coverage at the most inopportune time? Insurance litigators want to hear your story — and we might want to build your case. You deserve compensation more than they do. Don’t forget it.

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What Happens If You Don’t Have Insurance While In Quarantine?

There is a small amount of good news that has come out in the last few weeks: if you get tested for COVID-19, the disease caused by the novel coronavirus, you won’t be charged. However, if you test positive — it’s bad news whether you have insurance or not. Those with insurance can expect to pay thousands in out-of-pocket premiums, deductibles, copay, etc. Those without insurance can expect to pay tens of thousands in medical costs.

In other words, failing to procure insurance during this dangerous viral outbreak could cost you your livelihood. With millions of Americans already filing for unemployment benefits, we can expect that the number of insured will plummet. If you haven’t already started to see the economic cost of COVID-19, then you will soon.

There’s another small piece of almost-good news. President Trump is considering opening Obamacare applications during the outbreak. Although he’s doing this even as his administration sends the ACA to the Supreme Court to rule on whether or not the law is constitutional. He’s doing everything in his power to dismantle one of the greatest financial remedies to this crisis. 

It’s almost as if the world is screaming for him to stop.

Coupled with the news that President Trump wants to lift restrictions for travel and businesses as soon as possible, and it’s not difficult to see the writing on the wall: America is in for a world of hurt.

There are few legal remedies available to you when you cannot afford insurance in this time of crisis, whether it be health, home, or car insurance. Do your best to find coverage. If you can’t, then apply for unemployment and wait for the government to send you a check or two. Give a qualified insurance or employment lawyer a call to see if there are any obvious legal resolutions for your individual situation.

Did your boss fire you because you were sick?

Did someone purposely infect you with the virus?

Do you blame your employer for failing to take the right safety precautions?

Were you forced to work while sick?

All of these provide you with limited options for compensation, but at least they exist. There will be tens of thousands — or potentially even millions — of lawsuits in the coming months and years due to the coronavirus outbreak and the likely global recession that follows. We will do everything in our power to make you whole again. But first we need to hear your story!

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Insurance Litigation Expected To Surge Because Of Coronavirus

Many victims of coronavirus have been subjected to isolated treatment — and not always by choice. More often, quarantine situations are mandatory actions as a matter of course. But survivors of the novel sickness have begun to receive their bills. And when you were forced into isolated treatment, you might not actually expect a bill. This has left a lot of people asking whether or not insurance will cover treatment.

And for those of us who practice insurance law, different questions arise: will the number of new insurance cases skyrocket because people receive bills for treatment they didn’t actually want. 

Keep this in mind: the American system of medicine is steeped in choice. If you need treatment, you choose to go get it. Don’t have the money? Don’t want to risk a big bill? Many people avoid the hospital. But when someone screams “coronavirus” they don’t have a choice. They receive treatment whether they like it or not. Those who don’t have enough insurance are still subject to the insane costs of long-term care. That means new lawsuits are coming.

And that’s just health insurance!

A shocking number of Americans have already canceled international travel plans because of the spread of the virus, which is quickly spiraling out of control. Many didn’t have a choice in the matter, because of increased travel restrictions and bans to and from places like China. That means that people will also have questions and concerns about whether travel insurance will cover their broken travel plans. 

Most coverage isn’t absolute. That’s the point of insurance, after all. You’re paying a third-party to protect you from something, but that third party has only one job, really: to tell you no when you come calling.

That’s why it’s so important to read up on the insurance plan you want to buy. If you don’t see the word “pandemic” in the insurance agreement, you might be out of luck.

What’s covered? Generally, you won’t be covered by your travel insurance when the airline decides to cancel one of their flights. Usually, though, an airline will reimburse you whenever they remove a flight from the roster. It pays to check. Reimbursement might not include travel booked on the other end of the flight, though.

If you’re the one choosing to cancel your trip, then you’re almost never covered.

However, if you contract the virus or some other sickness, you’re almost always covered. If you’re put in quarantine, then you’re almost always covered — even if you never come down with the sickness. 

All insurance plans have limits and exclusions, so discuss them with the provider whenever something gets in the way of travel plans. All else aside, you might benefit from calling an insurance lawyer for help.

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Can We Make Coal And Oil Companies Liable For Climate Change Effects?

Remember when we held tobacco companies who made millions off of an addictive product liable for the damage that product caused? Yeah, well, some people are trying to apply the same kind of liability to coal and oil companies. Although the debate rages on, there’s no secret: burning coal and oil releases carbon into our atmosphere. Carbon is a greenhouse gas. That means it heats our planet. The more of it up in the sky, the warmer it is down here on the ground.

But lawsuits that would hold coal and oil accountable for the disastrous effects of man-made climate change (in part, at least) have so far been unsuccessful.

They came to a head when Exxon Mobil recently won a lawsuit lodged by New York State’s attorney general, who wanted someone to take responsibility for the damage that had been done. After all, that damage will last for centuries — or perhaps, even, forever.

But don’t think that it’s over just because the one lawsuit failed.

Students in Florida have sued state government officials for doing little to nothing to combat the growing effects of climate change. One suit went down the tubes, but another is showing signs of momentum before heading to court. Part of the reason is publicity. Public outcry can change a judge’s mind quite fast. 

Relatively unheard of in the 80s and 90s, climate cases multiplied dramatically in 2007 and then again a decade later in 2017. We expect they will continue to multiply in the future as more and more people begin to understand the real consequences of releasing greenhouse gases into the atmosphere like it would never make a difference.

Director of the Rockefeller Family Fund Lee Wasserman said, “Through these cases, we will learn with great detail what the industry knew and when they knew it, and what they did to deceive the public about that knowledge. They are now leaving the public with an enormous bill.”

And in fact that might make all the difference: We already know that many big coal and oil companies did their own internal studies on the effects of releasing carbon into the atmosphere. Those studies came to the same conclusion as other climate scientists have in the decades since, i.e. that releasing greater amounts of carbon will result in catastrophic weather events, sea rise, and mass extinctions on a greater scale than anytime in the history of the world.

And these cases will eventually change the way insurance companies sell, say, flood or fire coverage. For example, you can’t find flood insurance down in Key West because everyone knows that it’ll be underwater sooner or later — and probably sooner. And is that fair? Courts will soon have their say.

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Some Insurance Attorneys Forget They Are Held To A Higher Standard

There are plenty of cases in which attorneys fail to keep track of their clients’ actions — and are subsequently rebuked, sanctioned, or even slammed with contempt of court charges for not doing their job. But sometimes the tensions can run so high in important cases that a lawyer will start behaving like a rambunctious teenager. That’s what happened during an insurance litigation case against Allstate.

Attorney Christopher G. Hook wrote Allstate executives: “Pay up f—face.”

That was a somewhat inept attempt at persuasion for a lawyer trying to achieve a whopping nine-figure settlement on behalf of his clients, who may not have known that about his behavior at the time. Hook then wrote: “You are going to get [expletive] tattooed across the face.” Finally, “Tell Allstate I am going to water board each one of their trolls that show up for [depositions] without any mercy whatsoever.”

He then made personal threats to some of the Allstate attorneys, alleging that he knew where they lived.

Hook might have sounded like a shark had he managed to maintain some semblance of a professional attitude during the case. Allstate’s attorneys, not so surprisingly, decided to cut off correspondence when the cursing started.

When a judge decided Hook should stop practicing law, the reply was simple: it was all a part of smart negotiation!

United States District Judge Otis D. Wright II, who was appointed by George W. Bush, said, “Tell you what, slick, this profession does not need you. I am going to do what I can to remove you from this profession.”

Sometimes attorneys forget the far-reaching power of judges to make their lives — and the lives of their clients by association — an absolute nightmare. Hook refused to resign, prompting Wright to take up legal arms against him.

But resigning doesn’t matter if you have no more clients to represent. The homeowners quickly fired Hook when they found out about his backstage business with Allstate.

Hook seems to have pretended it didn’t happen, who wrote The Post: “I will continue to represent the interests of my clients and California consumers against the powerful interests of insurance companies.”

Hook defended his language by suggesting it was on par with what he experienced from insurance executives while defending them earlier in his career.

He said, “It’s a business that profits from risk and fear and human misery.” Having worked for such people a long time ago, he admitted, “I was kind of talking to myself.”

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Officials Warn To Be Careful Where You Buy Insurance Outside Federal Marketplace

It’s that time of the year again — time to sign up for Obamacare! Those who are currently without access to healthcare can browse through a number of plans on healthcare.gov. But health experts have warned would-be buyers looking for plans outside of the federal marketplace to watch out for the so-called “junk insurance” plans that have popped up due to new laws signed by the Trump administration. 

Those plans don’t meet the standards of the Affordable Care Act (ACA). 

The Supreme Court will soon hear a case that will determine whether or not insurers are reimbursed $12.3 billion to which they believe they are entitled. We should have an answer before the Senate goes on recess in summer next year.

According to insurer Land of Lincoln Health, the company is down over $75 million that it should have been able to recover from the risk corridor program under the ACA. 

Risk Corridors are a provision of the ACA. They “limit the risk borne by qualified health plans on the insurance marketplaces. Risk Corridors are a mechanism to minimize the year-end losses of insurers who covered a disproportionate share of sicker, often older, insured customers. The federal government, through the Department of Health and Human Services, agrees to cover 50% of the excess costs borne to insurers if those costs exceeded premiums by 3-8%.”

Land of Lincoln Health says that their monthly premiums were set low due to the provision. In addition, insurers Moda Health Plan, Blue Cross and Blue Shield of North Carolina, and Maine Community Health Options are all suing as well.

A federal appeals court has already ruled that the Risk Corridor provision of the ACA was non-binding, and that it was more of a description of what an optimal system should look like. The Supreme Court has been asked and subsequently agreed to review the previous rulings.

America’s Health Insurance Plans (AHIP) CEO Matt Eyles said, “The Supreme’s Court’s decision to hear this case recognizes how important it is for American businesses, including health insurance providers, to be able to rely on the federal government as a fair and reliable partner. Strong, stable and predictable partnerships between the private and the public sector are an essential part of our nation’s economy, and our industry looks forward to having this matter heard before the Court.”

Association for Community Affiliated Plans (ACAP) CEO Margaret Murray said, “We’re pleased that the Supreme Court has agreed to hear the case, as it gets to the heart of the concept of the full faith and credit of the United States government. We asked the appeals court in an amicus brief to affirm that the Federal government should be as good as its word in statute, and urge the Supreme Court to do the same.”