Reassurance on Health Reform
PHILADELPHIA – Just as he was delivering his opening speech to the annual meeting of the American College Health Association here last Wednesday, Jim Turner, the group’s president, got word that he was wanted at the White House that afternoon.
Though he was at his group’s biggest event of the year, Turner dropped everything and went, joining representatives of the American Council on Education, the other five presidential higher education associations, the National Association of College and University Business Officers, and the College and University Professional Association for Human Resources. He would later tell the ACHA board and many conference attendees that he was pleased with the meeting and with the reassurance he received on the fate of student health insurance plans.
And the physicians, nurses, psychiatrists and others gathered for the convention buzzed. At a Wednesday night meeting of the ACHA Student Health Insurance Coalition, attendees shared what little information they had: Turner had been called to meet with Nancy-Ann DeParle, director of the White House Office of Health Reform and Tina Tchen, director of the White House Office of Public Engagement. The meeting, a few said they’d heard, had “gone well.”
Based on what Turner said at a Friday morning at a session on health care reform, that rumor-mill assessment was an understatement. “It was just like a miracle, the Holy Spirit dropping from heaven,” Turner recalled to the chuckles of many of the 250 or so people in the audience.
College health professionals are unsure of what the Patient Protection and Affordable Care Act will mean for them and the students they serve. The ACHA had scheduled the Friday session well before the White House visit came on the horizon, but the readouts coming from Turner and C. Randall Nuckolls, a lobbyist with the Washington firm McKenna Long & Aldridge who works with the ACHA, became the focus. Members wanted to know what the association was doing for them, and the association wanted members to know it was advocating on their behalf.
Turner said that DeParle and Tchen were primarily interested in ensuring that colleges and universities would convey accurate information about the new law – especially its promise of extending dependent coverage under employer-sponsored insurance plans through age 26 -- to their students, parents and employees. “Nancy-Ann DeParle wanted to make sure the higher education community understood and was implementing the age 26 adult children on employee health insurance,” Turner said. “We all at the table said we all understand it, we all support it, we’re all implementing it.”
DeParle’s response, according to Turner, “ ’Oh, OK, well good. What are your issues?’ And everyone kind of turned at me and said, ‘ACHA’s got issues.’”
Following ACHA’s lead, the higher education groups shared with the staffers their concern that, because the new law eliminated the “limited duration” classification, student health insurance plans would, beginning in 2014, be rated as expensive individual plans and likely be priced out of existence.
DeParle had not been aware of the concern, Turner said, and stressed that President Obama’s promise that Americans who like the insurance they have would get to keep it applied to student health insurance plans too. Just as Congressional staffers told the higher education groups months ago, the omission of clarifying language allowing student plans to be rated as more favorable group plans was an oversight.
“It looks like we have an advocate,” Turner said of DeParle. “She said, ‘Tell me what you want written into the regulations and we’ll make it happen.’ ” The crowd applauded.
Nuckolls was a bit more guarded in his analysis. “I am not sure that everything is going to -- Jim says the Holy Spirit came down and said there shalt be no more problems – I’m not sure there’s going to be quite that much clarity,” he said. “I’m not certain that clear regulations are going to suddenly appear on tablets this summer to allay all of our concerns. I am quite clear, however, that there is commitment from the highest levels of the White House that they did not intend to cause colleges and universities problems with insurance offerings.”
One attendee at the White House meeting, M. Matthew Owens, vice president for federal relations at the Association of American Universities, said he thought the White House staffers “were receptive” to higher education’s concerns.
Another attendee, Steven Bloom, the assistant director of government and public affairs at the American Council on Education, conveyed a similar message. The well-being of student health insurance plans, he said, had “just fallen through the cracks” of “this huge, complex legislation.” He added: “It was very clear that they did not intend to hurt student plans and were very willing to work with us to resolve the issues.”
Moving forward, a fix might take the form of regulations or subregulatory guidance from the Department of Health and Human Services, the Internal Revenue Service or the Department of the Treasury, Bloom said. Legislation seems less likely “given where things are on the Hill.”
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