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Health care bill affects students’ lives

By Michelle Martínez, Gavel Media Senior Staff, on April 20, 2010 12:53 AM

By Michelle Martinez, News Editor -

With the pivotal passage of the “Patient Protection and Affordable Care Act,” the United States saw the culmination of decades’ worth of debate on health care reform. Whereas most of the discussion since then has been dominated by the effects on the elderly and on those with preexisting conditions, little has been said on the provisions that drastically change financial federal-aid to college students, as well as the general benefits young adults stand to receive.

Erica Williams, deputy director of Progress 2050 and senior adviser to Campus Progress, argues that “health care reform — and the under-publicized but far-reaching student aid reform that passed along with it in reconciliation — arguably constitutes the broadest, most meaningful, and beneficial legislative victories for young people in recent history.”

The quietly passed “Student Aid and Fiscal Responsibility Act,” also has a significant impact on the young American population.

“It is the largest investment in aid to help students and families pay for college in history — and at no cost to the taxpayer,” Williams said.

This bill puts an end to a prior subsidy program that had enriched banks and financial aid-service institutions by having them service the loan at a cost. More than $36 billion stands to be invested in the Pell Grant program over the next 10 years just by expanding direct government lending and removing the middleman in the financial-aid process.

President Barack Obama noted in his Weekly Address how 2 in 3 graduates take out loans to pay for college. “The average student ends up with more than $23,000 in debt,” Obama said. “So when this change takes effect in 2014, we’ll cap a graduate’s annual student loan repayments at 10 percent of his or her income.”

In spite of the apparent healthiness of people ages 19 to 29, government statistics show that this group constitutes nearly a third of the uninsured population. Also, more than half of all young adults have low incomes well below 200 percent of the federal poverty level. According to the Urban Institute, these low-income young adults are more than 2.5 times likely to be uninsured than higher-income young adults.

Cost barriers are also particularly problematic for young women, given that in 33 states insurance companies had been permitted to charge higher premiums based on age, gender, and health status without any restriction. This typically led to a 22-year-old woman being charged one and a half times the premium of a 22-year-old man, hike which can make the difference between affordable and expensive coverage.

Because of the expansion of Medicaid, nine million young adults will now have access to care and more than two million will be able to continue to be covered by their parents’ health insurance until they turn 26, as opposed to the prior cut-off age of 23.

“Since Massachusetts has mandated health insurance for college students for over 20 years, we probably will have less of an impact than other states who didn’t provide health insurance to their college student population,” said Nancy Baker, assistant director of Boston College Health Services.

“The current plan that is provided to students at BC exceeds the state law requirements for mandated benefits, as determined by the term, Qualified Student Health Insurance Plans (QSHIP),” Baker said. “Other colleges have lower limits of coverage.”

Judy Shindul-Rothschild, associate professor of nursing at BC, served on former Massachusetts Governor Michael Dukakis’ Committee for the Uninsured as a nursing representative. Shindul-Rothschild notes that the national health care reform bill passed by Congress is modeled after health care reforms adopted in Massachusetts.

“The provision to extend coverage of a family’s private health insurance for children into young adulthood is a provision that was adopted in Massachusetts under former Governor Dukakis,” Shindul-Rothschild said.

“Our mandate was to implement the provision in Massachusetts that would mandate all full-time students purchase health-insurance as a condition of enrollment in all universities in Massachusetts, demonstrate coverage under a parent or guardian’s health insurance, and extend health insurance coverage until children reached the age of 24,” Shindul-Rothschild said.

Shindul-Rothschild expressed how the fears and arguments proposed by critics and opponents of Dukakis’ reform never materialized, and in her opinion, are not bound to materialize as these provisions are implemented nationally. Amongst these concerns was the possibility of a marked increase in health care costs related to extending coverage to young adults.

“In Massachusetts, due to the concentration of universities in our state, approximately 17 percent of the uninsured at the time were full-time university students — the highest of any cohort in the commonwealth,” Shindul-Rothschild said.

Because of this, the Committee for the Uninsured worked alongside Massachusetts health insurers to develop reasonably priced plans to be purchased by families who lacked health insurance.

“By including this as a cost of enrollment, the costs associated could be considered in financial aid packages,” Shindul-Rothschild said. “We worked very hard at the Committee to negotiate low premiums and deductibles for students.”

Though Shindul-Rothschild considers certain provisions such as prohibiting exclusion of children from parents’ coverage due to a pre-existing condition as being long overdue, she is still concerned about the costs associated with the national health care plan.

“Hearings convened by Massachusetts Attorney General Martha Coakley specifically addressed skyrocketing health care costs in Massachusetts and concluded that the precipitous rise in health care costs was not due to the implementation of health care reform in Massachusetts in 2006 that mandated all residents purchase private health insurance,” Shindul-Rothschild said. ”Rather the Attorney General’s investigation concluded the rise in costs was due to market clout by a select group of providers.”

In her appearance at the Commonwealth for the Massachusetts Nurses Association, Shindul Rothschild recommended more regulations given the health care market’s failure to constrain costs.

“I believe such government oversight is critical because the health care market does not respond to competitive incentives as other markets,” Shindul-Rothschild said. “The national health care reform does not address cost-containment and without a public option, I am fearful, given our experience in Massachusetts, that costs will rapidly escalate.”