The Massachusetts health reform law has successfully expanded access to quality insurance at affordable rates for hundreds of thousands of residents. Yet, one group has been categorically excluded from the benefits of Massachusetts health reform: university students. Since 1989, university students have been required by law to purchase health insurance under the Qualifying Student Health Insurance Program (QSHIP), Massachusetts’ first individual mandate. Students who do not have health insurance through their parents are offered a plan through their university that is a cheaper alternative to other plans on the individual market.
Many Massachusetts universities—including Tufts University, where I am a student —have excellent on-campus health services that allow students to access excellent primary and preventative care. Nevertheless, the major medical coverage under the QSHIP plans offered by most schools is outrageously poor. These plans can include annual per illness or injury coverage caps as low as $50,000, as well as $1,000 – $1500 internal benefit caps for services such as high-cost surgeries, out-patient or in-patient care, and miscellaneous expenses.
The Student Health Insurance Project (SHIP) is uniting current and former students from across Massachusetts to fight for better student health insurance. Our goal is simple: provide students who are income-eligible Massachusetts residents with the same high quality affordability insurance that other residents receive under the new subsidized Commonwealth Care plans, and require that QSHIP plans meet the Commonwealth’s minimum coverage standards set by the Connector Board. We want to ensure that Massachusetts students are no longer forced to buy sub-prime health insurance.
This summer, SHIP leaders have spoken with dozens of Massachusetts students who have had bad experiences with their QSHIP plans. We met one student who is sometimes forced to choose between taking her depression and migraine medications because of a cap on prescriptions coverage. Another student will face a huge medical debt if she gets the life-saving surgery that she needs because her insurance will only pay up to $50,000. A third student tore his ACL and was forced to walk around crippled for months because he couldn’t afford the out-of-pocket expenses for surgery. A fourth student delayed care because he didn’t want to accumulate $1000 in unaffordable out-of-pocket costs. Unfortunately, the students that we have encountered only represent a fraction of those who are suffering from health access and financial problems caused by inadequate coverage under QSHIP plans.
SHIP leaders are in the process of recruiting new student members and meeting with the university administrators who choose their school’s QSHIP plans. In the coming months, we plan to meet with state agencies and key legislators to voice our concerns.
I urge any current or former students who have a QSHIP story to post a comment on this blog or contact me directly at aaron.marden@gmail.com.
Aaron Marden
Tufts University, Class of 2009
Lead Organizer, The Student Health Insurance Project
I think this project is great and really needed. When I was in college I had student health insurance and I barely used it because it didn’t cover anything. I ended up paying for almost everything out of pocket which is not affordable for most people.
It’s great that this blog focuses attention on the significant health insurance challenges that college students face! Higher education is a time to study and learn and not be confronted with weak health insurance support
It’s very hard to believe policy makers are not aware of the negative health insurance environment for college students. After all, presumably, they have children in college themselves, have staff and colleagues they consult with, and are well informed with regard to the college health insurance literature.
If the college health insurance situation doesn’t improve soon, perhaps American college students may consider the value added of obtaining their degree overseas in nations where the health care support for students is better than the US.
For anyone who is a college student, or who may have children who are college students, it may be worth your time to investigate this. An added incentive may be that tuition & fees costs overseas may be lower than in the US. This may not be so far fetched when we consider the trend toward off shoring including medical tourism and other areas in the health industry
If enough American college students vote with their feet and gain overseas college degrees, by the law of supply and demand the US college health insurance environment should improve
V/R
Mark Friedman
PS My family and I, with thanks to the Access Project & Health Law Advocates, are “survivors” of student health insurance.
A client from The Access Project’s medical debt resolution program asked me to post this comment on her behalf:
Shannon:
“I had multiple soft-tissue overuse-type injuries in late 2005-early 2006, which my insurance company (student health via BU) processed all as one claim. Given their per condition cap, essentially this amounted to trying to pay claims for only 1 condition instead of 4. I sent multiple letters to them, including spreadsheets that detailed exactly which claims pertained to which diagnois, and yet they continued to reply with new spreadsheets that simply re-arranged their bad math. It wasn’t until I threatened legal action that the matter was finally sorted out. To this day, they “investigate” every claim I submit, in order to delay payment.
I’m currently studying physical therapy, and so one current trend with all insurance companies is particularly relevant to me. Copay prices are skyrocketing (when I started grad school, an office visit was $10; now it’s $25). For something that requires multiple visits, such as physical therapy, this can impact service rendered substantially. For instance, consider a student rehabbing a re-constructed ACL. They’re told to see a PT, say, 2x/wk x 8 wks. The out-of-pocket cost difference is staggering, and may lead to the student missing treatment to save money– so much so that treatment becomes ineffective (think of it like only taking 1/2 of a cycle of antibiotics if you have strep throat– how much will it really help you?). In the future, the insurance company can use this as “evidence” that physical therapy as a whole is ineffective and should not be funded at all, which is exactly the opposite of the truth.
BU is taking steps towards decreasing the impact of this particular policy change. The Ryan Center physical therapy clinic has negotiated with Chickering/Aetna to decrease student copays in their clinic to $15/visit. This is great news! However, since it is to my knowledge the only PT clinic in the plan to have this lowered copay, it also leaves the BU clinic serving nearly the entire student body– some 30 thousand students, if I remember the figure correctly.”
My son has had to have health insurance through the college which has been very expensive, I wrote to Mitt Romney and asked what we could do as I am a single parent and we were trying to get cheaper insurance which we did not get any help with. It was such a waste of money that we now will owe back in loans as when he needed a check up at the doctors for school the insurance would not pay for it and also when he injured his leg playing football and went to the emergency room we had to keep on filling out forms of what happened where and when as they did not want to pay the doctors bill. So why are we paying for insurance if you can not use it for what you need to. My son now needs to go to a specalist for his eyes and he has high levels of Glacoma and was told that he could go blind if this is not taken care of and that he may need surgery for this. He is an artist, So what happens if his health insurance does not pay for this, what will we be able to do as I called so many places for three days trying to get him free care to take care of his eyes and was told that he can not get it. I want to thank The Access Project for all of their help as this is so important that some thing be done for college students. I also want to thank Andrew and Aaron for all the hard work that they have been doing.
Terry Collins Medeiros
This is a great article, which unfortunately has a lot of truth across the USA, not just in Mass. Student health insurance programs offered by most higher education institutions are not anywhere near what is offered in an employer based offering in terms of the benefits. The reason behind this is simple.. Cost! Most students will not be able to afford the cost of a robust program, and/or the University that is choosing the offering believe that the high premium of such a program will scare students away. The reason such programs are affordable under an employer-based program is because the employer is subsidizing the premium. On student insurance programs, the University typically doesn’t pay any of the premium.. not even a small fraction. Whereas, on an employer based program, the employer is paying anywhere from 50% to 100% of the cost for its employees and their families.
To offer a great program on the student side that mirrors expectations found on employer-based programs would mean premiums that are astronomical compared to what students are currently being charged.
Thank you this aricle is very important.
Thanks