A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Student Health Programs Advance, but Still Need Improvement. UMass Amherst Students Fight Back.

Student Health Programs Advance, but Still Need Improvement. UMass Amherst Students Fight Back.

August 4, 2011

Though most university students are healthy, they are not immune from becoming seriously ill or injured. In fact, over 15% of young adults live with chronic health problems such as asthma, diabetes, or hypertension. In addition, it’s essential that people of any age should receive annual check-ups and preventive care. Rightly so, Massachusetts requires its students to have health insurance, either through their parents’ or work’s health plan, or through their school’s Student Health Program (SHP). This ensures that students both receive the preventive care they need and have protection should any catastrophic injury or illness occur.

SHPs have been under attack in recent years because they are often costly and offer very limited benefits. A better option for low-income students not covered by their parents or workplace would be to purchase cheaper, more comprehensive Commonwealth Care health plans through the Health Connector. However, students are ineligible to enroll in these subsidized health plans, so they are left with limited choices based on which SHPs their school offers.

The Division of Health Care Finance and Policy released its Student Health Program Annual Report yesterday, highlighting important statistics and trends in the 2009-2010 academic year. Here are some highlights from the report:

  • Over 108,000, or 27% of university students in Massachusetts purchased health insurance through their schools.
  • On average, students paid $1,294 for student health programs, though premiums ranged from $325 to $6,143.
  • In most instances, SHP insurance carriers boasted lower medical expense ratios and higher profit margins than those seen in private insurance products in Massachusetts. SHPs offered at community colleges provided the worst value and least benefits to students of any school type, with an average 53% medical expense ratio and 32% profit margin.
  • 1,254, or 1.16% of SHP enrolled students exceeded maximum benefit limits for outpatient services. Most students exceeded benefits for prescription drugs (regulations do not require SHPs to cover prescription drugs), outpatient miscellaneous, high-cost procedures, and ambulances.
Students protesting UMass health insurance plan

Metro photo

The bad news is that student health plans still typically produce higher profit margins and lower medical expense ratios than the average private insurance plan. In addition, though many students did not reach maximum benefit limits, the ones who did likely incurred huge expenses. Added to the stress and debt from attending a university, outrageous medical bills are not something young adults should have to worry about. It’s clear student health programs need to deliver more comprehensive benefits that won’t limit (or refuse) coverage for benefits like prescription drugs that help students stay healthy and get the care they need without worrying about cost.

Students at UMass Amherst have been raising their voices for better health care on their campus. Their plan includes a requirement for 15% coinsurance costs for students trying to access health care outside the University. This means that Ob/Gyn visits, specialist appointments, hospitalization, and other services will have unaffordable out-of-pocket cost for students and student employees. A pregnancy or a chronic disease would cost a student thousands of dollars. A similar plan is being set for UMass Dartmouth. The students, held a protest on Friday, and have organized a petition drive, which you can sign. See the great Springfield Channels 6 and 40 news video report here.

The good news is that the average premium for SHPs was 3% lower than the last year, and greater improvement is on the horizon because of the Student Health Program Group Purchasing Initiative that was kicked off in 2009. This Initiative’s goal is to improve SHPs in public colleges and universities, including community colleges, whose plans have notoriously skimped on benefits for its students. Here are some of the accomplishments and plans for the Group Purchasing Initiative that were not included in the numbers for the 2009-2010 report:

  • In 2010-2011, state universities and community colleges offered SHPs without annual benefit maximums or per illness and injury caps on outpatient services, maximizing benefits and minimizing out-of-pocket costs for students.
  • Key improvements to SHPs being offered in the 2011-2012 academic year include adding prescription drug coverage for community college students, maintaining high-value SHPs for state university students, and eliminating benefit caps and improving access to care for many UMass students.

As an added bonus for students, HHS announced in February that the consumer protections for individual plans in the ACA will extend to student health plans. That means by January 2012, SHPs will offer improved access to preventive care, phase out lifetime benefit caps, and have medical expense ratios of at least 80%. In addition, some graduate students may benefit because now children under the age of 26 can remain on their parents’ health plan.

These added consumer protections and the improvements made by the Student Health Program Group Purchasing Initiative will work to provide better benefits at lower costs to students who struggle, as is, with heavy academic course loads and drained bank accounts. We hope next year’s report will showcase these successes.
-Amelia Russo