The federal government earlier this month brought to the forefront the debate over student health insurance with proposed regulations that could drastically increase benefits of student plans and require that these plans meet similar standards to those stipulated in the recent national overhaul of the health insurance system.
The proposed rule would vastly enlarge the benefits of Tufts' student plan, which is brokered through the insurance company Aetna. The U.S. Department of Health and Human Services (HHS) put forth the regulations and has now entered a period of public review.
Student health insurance plans have remained in limbo throughout the greater universal health care debate, according to Director of Health and Wellness Services Michelle Bowdler. Insurers, policymakers and university administrators often have not known whether the plans must meet the same standards that private insurance companies now face with regard to the general public, she said.
"People have been looking at student insurance for a long time because one of the concerns has been about how the plan has now evolved to bring more comprehensive coverage for students," Bowdler said. "It has to comply with some regulations for full universal health care, but not every regulation."
Individual private insurance plans can cost between $4,000 and $8,000 because of the more comprehensive coverage they offer to clients, Bowdler said. Tufts' current student plan costs approximately $1,500.
Students are typically healthier than members of the general public, which consistently results in less-expensive student plans, sophomore Daniel Markowitz, a member of the Student Health Organizing Coalition (SHOC), said.
Originally founded in 2008 by Tufts students, SHOC advocates improved benefits and lower costs for student plans across Massachusetts.
Bowdler said the cost of student insurance will inevitably rise over the next few years since colleges and universities like Tufts will likely implement changes to comply with the proposed regulations beginning in the 2012-13 academic year.
Health insurance is mandatory for all residents over 18 in Massachusetts, though many undergraduates opt to remain on their families' health plans, which typically offer more benefits than the student plan.
Since September, young adults nationwide have been allowed to stay on their parents' insurance until the age of 26 as a result of the Affordable Care Act President Barack Obama signed last year.
Coverage
One stipulation in the proposed regulations calls for an annual limit of at least $100,000 for essential health benefits. The stipulation would go into effect between January and September 2012. This would mean, for example, a large increase in the Tufts plan's maximum for prescription-drug coverage, which is currently $2,000, Bowdler said. Prescription drugs are included in the HHS definition if essential health benefits.
The majority of students do not exhaust this benefit, according to Bowdler, with only five to 10 students per year going over the $2,000 mark.
Still, Bowdler said the university would work to adjust benefits incrementally over the next few years in light of the proposed regulations. Administrators, she added, are currently considering options for improving student insurance.
"If there's one person who has an unexpected illness, we wouldn't want that one person not to be covered and have to worry about their health care," Bowdler said.
Students in SHOC believe the new regulations are moving student health insurance in the right direction and that current health care plans are inadequate, according to Markowitz.
"Students are required to buy health insurance, and if they're required to buy health insurance, they should be covered by plans that actually cover them," Markowitz said. "You should be promoting education, and you should be promoting your students. ... Any regulations that do help increase benefits, I think, [are] a very big step and a very important step."
Markowitz called the $100,000 maximum "very substantial."
Sophomore Brent Abel, chair of Tufts' Student Health Advisory Board and a member of SHOC, said the new maximum could mean a lot for students with pre-existing medical conditions.
Abel remains optimistic that the proposed regulations set standards that are achievable through negotiation.
"In order to get the cheapest price for Tufts," he said, "it's important to do a lot of bargaining with the insurance companies."
Cost
Bowdler, however, is unsure about how the proposed regulations will affect student health insurance costs at Tufts.
"I think it's OK, but I'm worried about the cost increases," she said. "I'm also confident that some of this will work itself out of the next few years."
Abel and Markowitz said sometimes a large amount of what students pay for their plans goes toward administrative overhead and not their health care.
As much as 30 to 45 percent of certain plans' costs do not go toward health care, according to Markowitz.
"One really important thing for bargaining power is that universities have to join together on this," he said. "The bigger your clientele, the more power you have."
Abel added that it was important to make insurance companies compete for Tufts' patronage by constantly comparing their benefits and costs.
