What do you think about mandatory health insurance for college students?

[Maddy McCall]

Recently, many American universities (80 at last count, I believe) are forcing students to buy insurance provided by an insurance agency selected by university officials. Some universities pay 100% of the cost for graduate-student assistants; most, however, pay only 50%.

For college students those fees can make the difference in whether or not they can attend college...sometimes going as high as $100 month. Even for graduate assistants, who make a pittance and who are already struggling to make ends meet, $100/mo out of a, say, $600/mo assistantship can be a prohibitive factor.

Students at these universities don't have a choice to opt out these universities' insurance plans, UNLESS they can prove that they already have comparable insurance. If they want to opt out, they have to fill out a waiver, and it is then the insurance companies' decision whether the student's current insurance plan is "comparable."

In Mississippi, two state universities recently passed this new rule, requiring students to enroll in insurance with The Chickering Group, a division of Aetna. Thing is, in Mississippi, many students have medicaid, and medicaid is, as far as I know, NOT considered comparable to the policy mandated by The Chickering Group. (That's how I found out about this tonight--a student called me in tears because she won't be able to continue her college education if forced to pay this monthly fee. She has medicaid, but medicaid is not considered "comparable" by the forced insurance provider.) Also, many students are on their parents' policies.

Also, any student who wishes to waive this forced insurance must give The Chickering Group the name of the company where they currently have insurance, and their policy number. This seems like an invasion of privacy to me.

Students cannot waive the insurance unless they provide details about their current insurance. Students cannot waive the insurance by simply saying that they can't afford it.

Students who apply to universities should check with the university when they are filling out applications, to see if this is required, because the student will not be informed of it until two weeks before the fall semester begins, and then they only have a two-week window to opt out. If the fees are prohibitive for them to attend that college, well, it'll be too late to apply at any other colleges for that school year.

I'm just wondering what DUers think about this. You know, I think that we want all Americans to have health insurance. But I think it is wrong to force people to have insurance. What if you work part time at McDonalds, and McDonalds began to force all employees to have insurance, and then selected the insurance company and plan, and took the fees for that insurance out of the employees' paycheck?

Anyway, it's a perplexing topic, and I was wondering what DUers think about it.

[Ilsa]

1. Seems like a way to weed out children of the working poor who

can't afford health insurance. I was covered on my dad's insurance until I graduated from college.

[Maddy McCall]

2. That's exactly what I was thinking.

It's become increasingly impossible for the poor to attend college, even at state universities. This could be the factor for many that ends their college dreams.

[Piltdown13]

17. Absolutely true...however, there's another side to this

I'm thinking here of students (especially grad students) who are no longer eligible to be included on their parents' policies. I attended grad school at a university that *didn't* require most of its students to have health insurance; the sole exception was graduate student appointees (i.e., teaching and research assistants), fellowship recipients, and international students, who were placed on the mandatory plan (part of the "package;" while I was on assistantship, we didn't pay premiums except for dependents). If you didn't have an assistantship, you could purchase the "voluntary" plan offered by the same company (NO option to buy into the mandatory plan), which was of course absolute crap -- I believe the lifetime maximum benefit was something like $50,000, no preventive care, etc. -- they couldn't get a decent "voluntary" plan together because naturally the insurance companies assume that the only people who will buy it are those who expect to need it. Essentially, those not on the mandatory plan either went without or had to buy insurance on the individual market, assuming they could find a company to insure them at a price affordable to a grad student. And, of course, woe betide the grad student who comes out of school and can't get a job that offers good health insurance (definitely a possibility, as universities begin to rely more and more on part-timers) -- that individual will be trying to buy health insurance on the individual market, and will be showing a period of at least 5 years with no coverage, a major red flag for insurers.

Now, unless universities are prepared to subsidize the cost, making insurance mandatory *will* price some out of the market for higher education; on the other hand, making it mandatory allows for a better plan to be assembled and offered (bigger risk pool). Just one more reason why I've come to believe that universal, single-payer health care is the only solution.

[gravity]

18. Most universities want to promote diversity

I don't think that it was the intention to weed out the working poor for school, even if that is one of the consequences.

It's probably just Aetena making a deal with the University, giving money for in return in forcing the insurance. If the rates the school offers is significantly lower than a comparable plan, than the school might think it is doing a service for the students, while having lower financial liabilities at the same time.

Either way, it just shows how messed up our insurance system is.

[TwilightZone]

3. Some universities have been doing this for a long time.

My wife went to a private university in Nebraska in the late 80s/early 90s. They were already requiring insurance coverage when she enrolled in 1989. As far as I know, they still are.

[Maddy McCall]

6. These are state universities.

[TwilightZone]

19. The reasoning is probably the same.

They probably consider it a liability issue.

[Donnachaidh]

8. How can they *force* you to buy insurance?

I'd like to know what the universities use as an argument to justify this? Are they claiming that they want to keep their insurance costs down?

Wow.

[TwilightZone]

11. If memory serves, the reasoning had to do with liability.

You could purchase coverage through the university's system, and it was actually pretty reasonable. That was almost 20 years ago, of course.

[Maddy McCall]

16. How does it have anything to do with liability?

How does forcing students to have health insurance reduce the university's liability? In what circumstance would health insurance protect the university?

[TwilightZone]

25. A student with no insurance falls down on an icy sidewalk on campus.

Who's liable?

To be clear, I'm not saying that I agree with the policy. I do, however, understand it, particularly in our rather litigious society.

[Maddy McCall]

32. So you think that people who have health insurance can't or won't sue?

I don't think you're correct about that.

An insured person who's injured on campus has just as much a right to sue as one who isn't insured.

[TwilightZone]

38. Well, why don't you contact the university and ask?

I suggest that you contact the university and ask them why they require insurance.

But then, since you're an expert on everything, I doubt you'll accept their answers, either.

Good night.

[Maddy McCall]

40. Good lord.

Are you always this terse when people want to discuss an issue?

[treestar]

46. True, I don't think this would cut back on lawsuits much

And the population in question is pretty much young and doesn't bother to sue for things like falling down. They just get up again and go on with their lives.

I don't see the problem for a university here. Even if they end up treating students for free at their hospital, isn't it a university hospital full of wannabe docs in training? And if none, then what's it to the university that the student has to go to a hospital.

[Lone_Star_Dem]

36. I'm not sure that's really a factor.

Once you figure in deductibles, and the simple fact that if negligence were involved most people wouldn't ignore it even with insurance, I can't really see this as a liability issue.

[TwilightZone]

39. Well, call the university and ask.

The reason we were given nearly twenty years ago was "liability".

But then, everyone else seems to be an expert, so I'll just discontinue discussing my experiences.

[Lone_Star_Dem]

41. I didn't suggest I was an expert

I simply said that the liability argument they gave you didn't seem convincing to me, and then explained why I felt that way.

I honestly can't understand how I offended you.

[Donnachaidh]

45. hey, even WITH insurance - if the university doesn't fix icy paths

they can and should be sued for medical costs of a fall. Any homeowner in the northeast will tell you that analogy doesn't wash very well.

The problem, it seems from reading the posts, is that universities started this quietly, students DID NOT question this, and now the Universities look at this as not only something appropriate - they are entitled to do this. And if they can work back door deals with their local insurance buddies - better for them, too.

Another example of the American consumer being handed a 36 page bill, deciding NOT to read it, and handing over their money. :wow:

[Donnachaidh]

4. I'd investigate the money trail on this *forced* nonsense

And I'd call the ACLU, because it sounds like a very sneaky way to discriminate against poor students that don't have wealthy families who can *subsidize* their health insurance.

I would NOT be surprised to see someone having *close friends and associates* at the *required* insurance groups. One hand washes the *other*, so to speak.

[Maddy McCall]

31. Yeah, I've got the feeling...

that there is some backscratching going on. It wouldn't be the first time.

[JDPriestly]

5. Way back when I was in college and attending a state university,

a small part of our fees went to pay for student health services. That's where we got our healthcare. It was great. Too bad that does not exist today. Students need healthcare. Usually, your parents group plan form their work will cover you until you are maybe 24. If that is the case, this is double dipping by insurance companies. A lot of parents don't have insurance at all. So, whether this is good or not depends on your situation.

I'm for universal healthcare for all paid out of one big pot of tax money.

[Maddy McCall]

9. Here's where it gets really sticky for students...

These universities in Mississippi that just enrolled in this forced insurance stuff also have clinics on campus. Until this began, students could go to the university health center on campus for a small fee or even free under some circumstances.

With the forced insurance, students will have to go to the campus health center for whatever ails them, no matter what ails them, and then they'll be referred out to a family doctor or specialist.

Thing is, many students don't live on campus, and commute sometimes 100 miles or more twice a week for classes. This means, if they get sick, they'll have to travel to visit the campus health center between the hours of 8-5, then be referred out.

If you get the flu in the middle of the night, and the campus health center isn't open, you'll have to go to the emergency room--and this insurance won't cover that visit if you haven't been referred through the campus health center.

I think this stinks all the way around.

[undeterred]

47. Yeah, thats how mine was too

Silly me, I thought it was still that way. It wasn't the best health care. But I was also still covered under my parents plan.

When I was a freshman my roommate disappeared one day. Turns out she had severe abdominal pain in class so they called an ambulance and took her to student health- which was unable to diagnose her. She demanded to be taken to a regular hospital, where her appendix was taken out, and I found her by calling hospitals. She had her parents insurance, fortunately.

[aikoaiko]

7. As a grad student, it was required for me...it was just another fee

There are so many out of pocket expenses that I looked at it as just another fee and a little more college loan debt. Still a good deal overall.

[Maddy McCall]

12. How much per month were you required to pay?

What if you're a student who doesn't qualify for loans or grants?

[aikoaiko]

27. It was about 600 a year I believe in the mid 1990s.

Well, my experience is that almost every grad student is qualified for one type of loan or another. There are several loans out there where the only qualification is to sign your name.

[Maddy McCall]

29. So your solution is to just go into debt to stay in college.

I don't agree with that.

The accumulated fees for this insurance could be as high as $5000 for four years.

[aikoaiko]

43. Going into debt is generally not a great idea, sometimes its a good investment.

Depending on the amount of debt and earning potential.

I went into debt to get my PhD. and I'm still paying it off, but my first year's raise was more than the minimum payments. So it worked out well for me. I've got a job I love with a lot of security, nice lifestyle, and room for advancement. I pay 350 month in loan repayments for that.

The debt-degree thing is a choice.

[Canuckistanian]

10. Pfeh. College students are invincible.

Just ask one.

[Maddy McCall]

14. You must know different students than I know.

Because the one I just talked to is worried that she won't be able to afford the forced insurance, thus won't be able to finish her M.A.

[Canuckistanian]

22. I was not speaking of their financial situation

Just their attitude to health in general.

I was like that in college. Go to the doctor? What for? It's hardly even bleeding... that much.

[Maddy McCall]

24. Many students are non-traditionals...

who are balancing the expenses of raising children with the expenses of going to college full-time, while working part-time.

I'd guess that at least 30% of most college student bodies are now older students.

They don't see themselves as invincible--they know how precarious their situation is.

But about younger students...yeah, you're right.

[fed-up]

13. my son could not afford-tuition has gone UP UP UP in CA, along w/books-he has not a penny to spare

[Maddy McCall]

15. Yes, this is what worries me about forcing it on students.

Either they buy the insurance, or they say bye-bye to college.

:(

[Igel]

20. I'm of two minds.

Seriously. I was against it at Oregon when I was doing my MA work. I didn't want to pay the additional money, pure and simple. It was moderately handy when I had to see a doctor, but it wasn't the doctor I'd have picked, and the insurance premium was far more than the one doctor's visit would have cost.

On the other hand, there were kids that really benefitted from the insurance--broken legs, autoimmune disorders, and the like. But still, the pool of participants was healthy enough that the program turned a neat profit for the company.

Then I went to UCLA. There are grad students--usually in public health and the medical sciences--that sit on the insurance committee and help determine coverage and argue about rates. Insurance was required for grad students, not for undergrads, at least when I was there. And it had the same problems: Most of the people were healthy and had a net financial loss, while some benefitted. My hernia operation, bronchitis, etc., etc. (I was in my 30s, so there were some medical problems) were covered. Child birth, however, was *not* covered for the few women that had kids, but I'm not sure about abortions; STDs were, for those that contracted them. So is this a good thing? Dunno. But if you needed medical care, the main provider was a very good teaching hospital.

At Oregon, it was an honest vote that instituted insurance. They held the vote, you could vote yes or no, and the majority won. At UCLA, the vote was before my time, but grad lore was that the vote was moderately dishonest: It was done in such a way that the TAs and RAs knew that if they voted 'yes' they'd have free insurance, and they had a large turnout, what with pro-insurance pamphlets in with their pay checks; those that actually had to pay for their own grad fees were generally against it, but were less motivated to vote when the surprise vote came along.

While in both cases it made mandatory fees higher, it also increased the amount that financial aid covered, so poor students would get aid to cover it. The poorer the student, the more likely it would be an out-and-out grant; since the amount of grant money was fixed, however, it meant the grant money didn't reach as high up the income ladder. But it also meant that students with a sudden medical expense wouldn't be financially crippled by it--you break a leg, and you don't have to worry about more than a low copay. It would be poorer students who would be forced to drop out for medical expenses, so I'm not sure how "regressive" a "tax" it would be when all is said and done, even if it ups the amount of student loans. But that's just in my experience; I know I could construct a plan that would be downright hateful (even though I've yet to run into an administrator that wanted to keep poor kids out of college).

In both cases the guidelines for 'equivalent coverage' were very explicit. If your insurance was rejected as not equivalent, there were alternative ways of having it evaluated--and, to be sure, it was a simple enough task to run down a checklist.

Medicaid/care wasn't at issue here, so that needs to be taken into account. And while you say that the insurance company evaluates your present coverage, that strikes me as probably incomplete; it might well be true, but if you did you may find that ultimately an administrator has final say. Handing over the insurance policy number is fair game, in my experience: It provides confirmation that you're not lying about coverage, even though I'd personally rather an administrator do the checking.

But like I said, I'm of two minds. I don't like the idea of forcing kids to pay for insurance; on the other hand, it's kind of nice to know that if one of your students has an injury s/he won't have to drop out of school because of the expenses. (With, of course, a caveat: If you're working to pay expenses anyway, an injury can still kill your cash stream.)

[Maddy McCall]

26. There is no doubt that it's beneficial to have health insurance.

But forcing students to pay a monthly fee that many can't afford can have two results:

1) They go into debt just to stay in college. Over four years, this could be close to $5000/debt just for insurance.
2) They quit college.

Like I said, these students have to prove that they have comparable policies...even though they may be satisfied with their insurance plans, the insurance company or college administration can determine those policies non-comparable. Then they have to buy the insurance provided by the specified company, or leave the college.

And what about the students on medicaid?

Edit to add: I do appreciate your post, and I'm not trying to be argumentative. I really want to hear what everyone thinks about this. Thanks for talking about your experiences. There was never any kind of student or grad-student vote related to student insurance at the university that I'm talking about.

[fed-up]

44. don't forget to add cost of interest since any insurance premiums will likely be charged to a cc nt

[Lone_Star_Dem]

21. A portion of my daughters tuition goes toward student health services

It's a very small portion and well worth the price. They also offer insurance to cover emergency care and the times when classes are not in session. However, this is not mandatory and it is actually quite reasonable.

If her university were to make it mandatory that she carry a traditional insurance policy I don't see how we could afford to keep her in school. She and I are both already working as much as we can to make our bills and her tuition fees.

I have a feeling that this will have that same effect on others where it implemented. I'm sure that was weighed and considered somewhere along the line before they came to this decision. It would seem to me that this also will reduce the number of students who qualify for FAFSA from attending universities.

All things considered, I have to say I think this stinks. People such as my daughter have just as much right to an education as those with more disposable income.

[Maddy McCall]

23. Yeah, but I'm not talking about fees for the campus health center.

I'm talking about forced insurance, which has a monthly premium, which the student must pay.

And I agree with the rest of your post.

[Lone_Star_Dem]

28. That wasn't my most coherent post ever.

And I even edited it! Teach me to talk on the phone and post. :P

I was originally attempting to say that that how my daughter's university is doing things is more like how it should be done.

All I see forcing students to hold individual health insurance policies doing is removing the possibility of an education from many young people's futures.

[Maddy McCall]

30. I agree 100% with you.

:D

[SheilaT]

33. In 1982 I was attending the University of Minnesota

part time, and some portion of my student fee paid for health insurance. Which was quite convenient when I tripped and fell down a flight of stairs on campus and broke a leg. I had no other health insurance at the time.

I think something should be included in the fees. I now have a 20-year old attending a private University, and I was reading over the health insurance plan they offer, and it looks like a fairly standard kind of policy. They want $894.00 for a full year's coverage (8/11/07 - 8/11/08). The cost of adding a spouse ($2,978.00) or children ($1,985.00) seems rather steep to me. But he's still covered under his father's workplace policy, so we don't need this.

The real problem is that we don't have universal health care in this country.

[Maddy McCall]

34. Will your present insurance be enough for you to get the waiver for your son?

Have you seen the waiver form you'll have to fill out? The way it was described to me, it's an invasion of students' privacy.

Please keep us updated on whether or not you university will allow your son to opt out of the forced insurance.

[SheilaT]

48. He's attending the

University of Tulsa, which is a private school. Their insurance is not mandatory as far as I can tell, and the paperwork they sent says nothing about needing a waiver. Wish I could be more helpful.

Frankly, I'm appalled that insurance isn't included in the tuition and fees, whether at a public or private school.

[Liberal In Texas]

35. Short answer YES. Longer answer, EVERYBODY SHOULD HAVE HEALTH CARE. Period.

I don't care if you're a college student, a congressman, an president, or a longshoreman.

If you are a visitor from Mongolia or Chad or some UFO from another planet, you should have health care if you are sick in this country. And you shouldn't have to pay for it.

[bemildred]

37. We don't need insurance, we need a universal public health care system.

We don't need "coverage", we need access to health care. Health insurance is a dodge and a racket and always has been.

[bridgit]

42. read flatly being 'forced to buy insur from selected underwriters' seems like a shakedown...

of some kind,

to my mind it would be easy for some group of alumni to steer funds from out the pockets of otherwise pie-eyed folk to their own kith & kin, a niece or nephew perhaps, or some consortium of clearly-for-profit facilities,

i would think it incumbent upon whomever is constructing these instruments to offer a plan out from under the specter of impropriety, and beyond reproach

there's too fun monkey business in the HMO world as it is, and they seem forever as though trying to carve out evermore profit

all this new expense while tuition, books, lodging, food, gas auto insur climbs through the roof by the tic-toc tic-toc?

if it were me so forced, my hope would be that any such a medical plan include comprehensive counseling/mental services as well

[Nikia]

49. In order to participate in varsity athletics

I had to have health insurance. There was an on campus health center though in which you could be seen for free by the nurse or pay $10 to see the doctor.