The Affordable Care Act, commonly referred to as Obamacare, is one of the largest and most complicated pieces of legislation in the history of modern government. Created and written to provide health insurance for those who would probably otherwise go without while also trying to take the needs of insurers into consideration, it is also one of the most controversial.
The Act covers everything from payment terms for medical procedures to penalties for failing to participate in an approved plan. The Act seemed to aim for a complete reformation of the regulations that governed key aspects of billing, compensation, and even litigation.
However, the very impermanence of the ACA is keeping health care providers liable for potentially unlimited amounts of recovery in medical malpractice claims even though such limits were a key tenet of the initial legislation.
The reason?
The ACA is, for all intents and purposes, still temporary. And, a case in New Jersey is shining a very bright light on what can only be described as a textbook definition of the law of unintended consequences.
Nine-year old Ella Pannacciulli was born with cerebral palsy as the result of what her parents claim was medical malpractice. The hospital, doctors, and others named in the medical malpractice lawsuit argue that their financial responsibility should be limited because much of the plaintiff’s care and future needs will be covered by the Affordable Care Act. However, Bergen County Superior Court Judge Robert Wilson disagrees.
Highlighting the fact that “…Congress has sought to repeal and/or undermine the ACA over 50 times,” and that the “longevity of the ACA is overwhelmingly called into question by the upcoming governmental elections,” Judge Wilson says that the resulting uncertainty means that Ella and her family have no real guarantee of future medical coverage.
That means that there is no limit to the amount they can claim in their medical malpractice lawsuit. This is surely a significant relief for the parents of a girl whose future medical coverage could cost upward of $4.5 million.
Attempts by defendants to use the ACA to steer future medical costs away from themselves and onto the government are increasing. But judges like Judge Wilson acknowledge that leaving these families’ futures in the hands of a piece of legislation under constant assault is not viable.
There is, in fact, precedent for Wilson’s decision. When making his ruling, Judge Wilson cited an unpublished case in New Jersey courts: Puzio v. Mimms. The Court relied on Puzio in ruling “future benefits that are contingent, speculative or subject to change or modification cannot be deducted from a claim for future medical expenses.”
Translated, that means that unless the source of future funding is solid and guaranteed, you can’t offload your responsibility. This means that the very limits to medical malpractice recovery that Congress was seemingly so desperate to implement may never come to fruition simply because that same Congress can’t stomach the idea of a world where every citizen is guaranteed access to high quality healthcare.
