Crisis on Campus : Student Access to Health Care

College-aged adults are overrepresented in the uninsured population in the United States, and traditionally underserved minorities are disproportionately affected. Further, students with private health insurance are functionally uninsured as well, since most schools refuse to accept this traditionally elite calling card on campus. Consequently, the large uninsured and functionally uninsured population often rely on school-sponsored health insurance plans for access to care. Yet these plans are uneven in their coverage, limited in benefits, often have exclusions and high cost sharing amounts, and provide little health care security for their beneficiaries. Further, schools and insurance companies have been found to have profited substantially off of these student plans, raising the concern that there is a conflict of interest associated with school-sponsored plans that may be focused on benefits to the school rather than the student. In addition, these plans may violate public policy and consumer protection laws by charging those who do not enroll in school-sponsored plans higher prices and by disingenuously claiming "competitive" rates in comparison to community charges when advertising to students. Public efforts at a student mandate, such as in Massachusetts, although successful in increasing the number of students with health insurance, have failed to provide adequate access to care. A focused policy must be put into place to ensure students can effectively and efficiently access adequate health care services on campus. A proposed statute is provided herein in an effort to do so. The bill amends the Higher Education Opportunity Act to create a student health insurance mandate. School-sponsored plans as well as private plans with comparable coverage would be required to fulfill a minimum standard benefits plan. Reasonable exclusions and limitations would be allowed that are based upon standard commercial health insurance plans. A required percentage of premiums in school-sponsored plans to be spent on health care services would be mandated, with any excess rebated to students if this level is not met. The statute would also require that schools accept a student’s private health insurance for campus services to avoid students paying more than once for services. As part of this mandate, with the surpluses often experienced by schools billing private health insurance, a portion would be allocated to create health insurance scholarships for uninsured students. Finally, to ensure that federal financial aid calculations take into account health care insurance premium costs, the definition of cost of attendance would be changed to expressly take into account health care for students enrolled in a higher education institution