Author name: patrick@greemantoomey.com

Today the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act colloquially known as “Obamacare.”  For the vast majority of our clients, the most important result of today’s ruling is the broad expansion of Medicaid, the joint federal-state insurance program for people with low incomes.  The Affordable Care Act expands insurance coverage to an estimated 17 million people over the next 10 years.  Specifically, the Affordable Care Act expands Medicaid coverage to people with less than 133% of the federal poverty level ($14,856 in 2012.)  This will have the greatest impact on single adults without children, as those with children are typically already eligible for coverage under most states’ requirements. While the decision found it unconstitutional for the federal government to punish states who declined to offer the expansion of  Medicaid to its residents, it also acknowledge that as a practical matter, most states will likely accept the federal funds and offer coverage to its poor and uninsured.  This is good news for our clients.  Every day our office talks to seriously ill people without access to healthcare insurance.  The problem seems to be particularly acute in Wisconsin, where drastic austerity measures have left hundreds of thousands of state residents would access to vital healthcare services.  Two examples come immediately to mind: An epileptic women who has been turned away from her neurologists’ office because she could no longer pay hundreds of dollars out-of-pocket for the routine visits required for continued prescription of anti-seizure medications.  Now, she has seizures requiring emergency room care and hospitalizations multiple times per month. The seizures may be causing permanent, long-term brain damage, but she does not qualify for insurance and is too sick to work. A woman with extraordinarily painful diabetic neuropathy in her feet, who is on the waitlist for coverage but who presently has to be carried around because she cannot put any weight on her feet. Her diabetes had been controlled with insulin before she lost her health insurance coverage. Millions of other Americans are in similarly dire straights. Under the Affordable Care Act, if states allow the federal government to fund expansion of Medicaid coverage, our clients will at least be able to see a doctor and receive treatment for their conditions while they’re waiting in line for a hearing before an Administrative Law Judge – great news, since according to recent congressional testimony, the average wait time is 340 days.  The decision is also great news for the judges hearing Social Security cases, since their decisions are largely made based upon objective medical evidence.  Once the Affordable Care Act is fully implemented, the courts will have better documentation of our clients’ physical and mental health impairments.

Here’s a recent Washington Post article about the projected depletion of the Social Security disability trust fund by 2016.  According to the article, the aging baby boomer population and the country’s economic troubles have placed increased strain on the program over last several years – applications have risen more than 30 percent since 2007.   If the program runs through its reserve incoming payroll-tax revenue will only cover 79 percent of the benefits.  And, since the program is barred from running a deficit, benefits would then be cut to match revenue.   According to the article, this fast-approaching depletion has yet to inspire a concerted effort by lawmakers to find a solution.  

According to a recent article in the San Francisco Chronicle, the San Francisco office of the Social Security Administration has been ordered by a federal judge to accommodate the needs of two men with learning disabilities, schizophrenia, and autism.  The men were wrongfully denied their benefits because they were unable to understand the complex Social Security rules and regulations. While the legal settlement only applies to the two men who sued the agency, it might have far-reaching implications for other Social Security Offices that routinely deal with mentally ill and intellectually disabled clients without offering any accommodations.

Check out this recent Wall Street Journal article about Administrative Law Judge Gerald Krafsur. Judge Krafsur has been a Social Security judge in Kingsport, Tennesse since 1991.  According to the article, he was one of the most productive judges among the roughly 1500 Social Security judges nationwide, and had one of the highest approval ratings.  (You can find statistics of the approval ratings from all judges here.) He also, according the article, took the initiative to ask applications about symptoms indicative of psychiatric impairments, including Post Traumatic Stress Disorder. Apparently, inquiring about impairments and approving applications is suspicious judicial behavior.