Keeping Student Health Affordable

Higher ed asks Congress to tweak its bill to ensure that college-based plans aren't classified as pricier "individual" policies.
January 12, 2010

WASHINGTON – Two major groups representing higher education have called on Congressional leaders to work to protect campus-sponsored student health insurance plans in the final health care reform bill being hashed out by Democrats behind closed doors this month.

In letters sent last week to top members of the Senate and House of Representatives, the American Council on Education and the American College Health Association ask that the final legislation specify that college- and university-based student plans are not individual plans, but are instead “group-like” and should be rated and priced based on the relatively healthy student population rather than the insurance market at large.

Passed on Dec. 24, the Senate’s bill -- widely expected to look more like the final draft than the House’s – specifies that it does not “prohibit an institution of higher education … from offering a student health insurance plan.” But ACE and ACHA argue that without revision, the legislation does nothing to stop student health policies from being characterized as individual plans, open to people not affiliated with the college or university offering a plan and losing the benefit of group ratings.

Molly Corbett Broad, president of ACE, warned in a Jan. 8 letter that the default classification of student plans as for individuals “threatens the ability of colleges and universities to continue to offer students group-like insurance plans that are both high quality and low cost.” The letter, which was written on behalf of eight other groups, including the Association of Public and Land-grant Universities, the National Association of Student Financial Aid Administrators, and the Association of American Universities, was sent to Sens. Harry Reid (D-Nev.) and Mitch McConnell (R-Ky.), and Reps. Nancy Pelosi (D-Calif.) and John Boehner (R-Ohio).

White papers included with both letters suggest that the final bill make clear that “student health insurance coverage shall not be considered to be offered in the individual market.”

With the language proposed by ACE and ACHA, plans would have to be offered by Higher Education Act-defined “eligible educational institutions” and available to students and dependents without regard to health status. At minimum, they would have to meet the standards of what the current legislation calls the “Bronze Plan,” essentially catastrophic coverage.

The absence of language in the Senate bill on how to characterize student health plans “seems to be inadvertent,” said Steven M. Bloom, assistant director of federal relations at ACE. “Read in combination with other sections of the bill, our plans would be lumped into the individual markets, which we don’t think is Congress’s intention.”

Mary Hoban, director of the ACHA-National College Health Assessment office, said her group didn’t think the Senate bill was “intentionally designed” to make student plans less affordable. “My sense … is that there are a lot of things that need fixing in the bill, this is just one of them, and the legislators involved have so many demands on them.”

But this is not the first unintentional omission of student health insurance from the legislation working its way through Congress. The Senate Finance Committee’s draft bill, passed in October, seemed to outlaw any plan that was neither employer-based nor individual, leaving no room for student plans. At the time, James C.Turner, president of ACHA, told Inside Higher Ed that “Congress simply isn’t thinking about college students’ health care.”

Soon after the article quoting Turner ran, some higher education representatives were able to meet with Congressional aides, a meeting that led to the language in the Senate bill. Turner said the staffers acknowledged that they had made an oversight.

James A. Boyle, president of College Parents of America, said in an e-mail message that the ACE and ACHA proposal “makes sense.” In the past, he has been critical of student health plans.

Before the final bill is drafted, though, he hopes to see even more revisions regarding student health. “I suggest that Congressional leaders go a step further and add language mandating that campus health centers offer a choice in plans to their students.” Many health centers, he said, do not accept any insurance policy other than the campus plan, forcing students covered by a parents’ plan to pay for additional coverage just to be sure they can be cared for on campus.

ACE and ACHAwere in their letters largely complimentary of the legislation. Both letters applauded the extension of dependent children’s coverage to at least age 26.

Broad, though, hurled another criticism, expressing concern “about the impact of future increases in Medicaid costs on state funding for public higher education institutions and state-based student financial aid programs” and asking that the final bill include “additional ways to insulate state from increased Medicaid costs in the future.”


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