Destabilizing the Student Insurance Pool?

College health experts are worried new rules from the Trump administration will result in students, particularly graduate students, paying more for health care.

August 3, 2018
 

Professional associations fear that the Trump administration’s new rules on health insurance could raise the cost of plans that institutions offer -- and lead to some college students, particularly graduate students, paying much more for health care.

The administration on Wednesday released the rules, which allow Americans to purchase cheaper, shorter-term health-care plans that last up to a year and are renewable for up to three years.

While the premiums for these plans -- which were disincentivized under the Affordable Care Act -- are much more inexpensive than those for ACA plans, the plans also don’t always provide the same coverage options, such as maternity care or prescription drug coverage. They also could impose annual or lifetime dollar caps that the ACA forbids.

The plans that colleges and universities offer to students meet ACA standards. Associations such as the American Council on Education and the American College Health Association have described these as "quality" plans.

The fear is that students might switch to shorter-term plans instead of those offered by institutions, said Steven Bloom, ACE's director of government relations. The shift could drive up the cost for students who remain on the university plans, because as fewer people stay on these plans, it would cost more to insure them, Bloom said.

This would be particularly detrimental to graduate students, some of whom are financially strapped and older than 26, so they can’t remain on their parents’ health-care plans, as ACA allows. Universities often subsidize health-care plans for graduate students, but if they got too pricey, this perk could be eliminated and lead to graduate students paying much more, Bloom said.

According to a 2017 ACHA survey of more than 63,400 college students, about 18 percent -- both undergraduates and graduates -- relied on a university health-care plan. However, about 47 percent of graduate students were on the university plan.

Devin Jopp, chief executive officer of ACHA, said his group is concerned with the quality of the short-term plans. Trump’s administration “on the surface” was trying to offer choice, but it’s more “the illusion of choice,” he said in an interview with Inside Higher Ed.

“Many of these insurance products we would anticipate would have high thresholds with paying for anything,” Jopp said. “These students who need things taken care of, that have routine issues, who need to be seen, oftentimes end up stuck with a bill. Some of the deductibles can run in the thousands of dollars, and that then creates a financial burden on top of the insurance that didn’t offer proper coverage.”

ACHA will be publishing “Healthy Start” -- an online guide to health and wellness for college students and institutions, which will include a walk-through about purchasing health insurance, Jopp said. The association will also be lobbying Congress “to make them aware of the damage possibly that’s being done here,” he said, with the goal of legislation that could reverse Trump’s actions.

Senate Minority Leader Chuck Schumer, a New York Democrat, pledged in a statement that “Democrats will do everything in our power to stop this.”

The associations’ concerns essentially represent on a smaller scale what health-care experts worry will happen across the country. As more people (generally younger, healthier citizens) depart from ACA-supported plans, the costs for those who stay on them will continue to rise, experts predict.

Conservative groups and lawmakers, however, have praised the change. The conservative Heritage Foundation called the administration’s health-care plans “ambitious” and “positively Reaganesque.”

“In health care, the progressive paradigm is tiresomely familiar: centralized control, top-down decision-making, and reliance on government coercion rather than persuasion,” wrote Robert E. Moffit, a senior fellow in the Heritage Foundation's Center for Health Policy Studies, analyzing remarks made by Health and Human Services Secretary Alex Azar.

“Conservatives have an alternative paradigm, based on decentralized power and personal freedom. The task is to transform that superior vision into reality, and craft consequential health reforms that will lower cost and expand coverage choices for millions of individuals and families.”

A recent report by the Lookout Mountain Group, a collection of university health officials and other experts who came together to study health-care reforms after Barack Obama’s election, indicated that ACA helped reduce the number of uninsured students.

The percentage of students without health insurance dropped from about 19 percent in 2010 to roughly 9 percent as of 2016, the study shows. The organization found that about 1.7 million students still remain without coverage. In states that did not expand Medicaid, about 11 percent of student population was uninsured.

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