When President Barack Obama made history by signing the Affordable Care Act into law on March 23, 2010, it was a major step forward for Americans, particularly young Americans, making it possible for them to get the quality, affordable care they need and deserve.
Another historic moment took place when one of the most important provisions of the new law went into effect, last September requiring insurance providers to allow college students and young adults to remain on their parents’ insurance longer – until the age of 26 – while they finish school, look for a job or start a career.
Expands Affordable Coverage to Millions of Young Adults
First, since the law allows adult children to stay on their parents' health plan until age 26, it is estimated that as many as 1.2 million previously uninsured young people could gain coverage through this plan. Many more will be able to upgrade their currently inadequate coverage to the improved benefits offered by their parents’ coverage.
Second, the law expanded Medicaid, a very low-cost government insurance program, to cover people making under $14,400 a year. Almost eight million uninsured young adults could benefit from this affordable insurance option.
Third, the law created tax credits for those purchasing insurance who earn under $43,000 a year. Roughly three-quarters of young people ages 19 to 29 are in this category; relatively few of them have employer-sponsored coverage.
The new law will not cover every young adult or ensure that all covered young people receive quality insurance. Up to four million young adults will end up with so-called "catastrophic plans" that offer minimal benefits before enrollees must pay a deductible of nearly $6,000.
Protection for Consumers
The law will prevent insurance companies from denying people coverage based on a pre-existing condition, raising rates after people get sick and canceling an existing policy to avoid paying claims, according to Rear Admiral Clara H. Cobb, regional health administrator for the U.S. Department of Health and Human Services, who served as a panelist for CAU’s recent town hall forum, “The Impact Health Care Reform in Impoverished Communities.”
The forum, which was presented by CAU’s Center for Cancer Research and Therapeutic Development in January 2011, was held to spur community discourse on how health care reform will affect consumers and college students.
L-R: Dr. Shafiq Khan, director of CAU's Center for Cancer Research and Therapeutic Development; former U.N. Ambassador Andrew Young; Anton Gunn, regional director, U.S. Department of Heath and Human Services; Rear Admiral Clara H. Cobb, regional health Administrator, U.S. Department of Heath and Human Services; and Dr. Carlton E. Brown, president, Clark Atlanta University.
Making it Easier to Buy Insurance
The new law makes insurance easier to compare and buy by creating online exchanges. Each state will have responsibility for creating an exchange so that individuals can compare plans and purchase the package that works best for them.
Lawmakers anticipate that the online exchanges will help to reduce prices and improve the quality of insurance plans.
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Five Questions for Anton Gunn, Regional Director, United States Department of Health and Human Services
Anton Gunn
Pathways: When you spoke at CAU’s town meeting “The Impact of Health Care Reform in Impoverished Communities,” in January, you gave an overview of what The Affordable Care Act means to Americans. Could you speak specifically to college students and tell them the most important things they should know about this legislation?
Anton Gunn: On March 23, 2010, the Affordable Care Act was signed by President Barack Obama and became the “law of the land.” The Affordable Care Act includes various health care provisions that have many benefits to all Americans, especially young people. Because of the Affordable Care Act, young people can now stay on their parents' health insurance until the age of 26. This is a new opportunity for young people due to the Affordable Care Act. In addition, insurance companies cannot deny or exclude coverage for students under age 19 because of a pre-existing condition.
Pathways: You spoke about three phases of the legislation: private insurance reforms, health insurance exchange and shopping online. Would you describe speak to these phases?
Gunn: When the Affordable Care Act is fully implemented in 2014, individuals and small businesses will have access to affordable coverage through a new competitive private health insurance market – state-based Health Insurance Exchanges.
Health Insurance Exchanges will provide individuals and small businesses with a “one-stop shop” to find and compare affordable, quality health insurance options. With these Exchanges, Americans will no longer be on their own in trying to find comprehensive, affordable health coverage.
Exchanges will bring new transparency to the market so that consumers (buyers) will be able to compare plans based on price and quality. For example, as a consumer, when you are looking to purchase a car or even a cell phone, there is a consumer report available for comparison.
Ultimately, by increasing competition between insurance companies and allowing individuals and small businesses to band together to purchase insurance, Exchanges will lower costs.
Pathways: What should/can college students do now to take full advantage of The Affordable Care Act?
I encourage students to visit www.healthcare.gov to get up-to-date information about the Affordable Care Act. This website also provides state-by-state implementation of the law and various grant funding opportunities made available or awarded to states.
Pathways: Recently, there was an announcement on proposed regulation regarding the consumer protections available to college students. What do you see as the most important aspect of the proposed new rules?
Gunn: On February 9, 2011, a new proposed regulation was announced by the U. S. Department of Health and Human Services ensuring students enrolled in health insurance coverage through their college or university benefit from critical consumer protections created by the Affordable Care Act. Because of this new regulation students enrolled in college plans now have freedom from worrying about losing their insurance, or having it capped unexpectedly if they are in an accident or become sick. Ultimately, this new rule will allow college students to take more control over their own health care.
Currently, student health plans are often purchased when family coverage is not available, or is unaffordable. There are approximately 1,500-2,000 institutions of higher education across the country offering some type of health coverage. The proposed regulation would ensure that students enrolled in these plans benefit from important consumer protections created by the Affordable Care Act by clarifying that these plans will be defined as “individual health insurance coverage.”
Under the proposed rules, some of the new health insurance protections include:
· No Lifetime Limits on Coverage: Insurance companies would no longer be able to impose lifetime dollar limits on the amount they spend on health benefits in student health plans.
· No Arbitrary Rescissions of Insurance Coverage: Insurance companies can no longer drop coverage when student health plan enrollees get sick because of an unintentional mistake on an application.
· No Pre-Existing Condition Exclusions for Students Under Age 19: Insurance companies cannot deny or exclude coverage for students under age 19 because of a pre-existing condition.
Pathways: Is there anything else the young people should know about the Affordable Care Act or new proposed rules for college students?
Gunn: Please visit http://www.healthcare.gov/ to stay informed about this historic legislation – the Affordable Care Act.
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A Closer Look
Five Ways Healthcare Reform Impacts College Students
When President Barack Obama signed the healthcare reform bill into law on March 23, 2010, it was an historic piece of legislation that signaled a new beginning for American health care. Though health care reform laws will not be enacted all at once, Americans will have better access to inexpensive health insurance with comprehensive coverage over time.
College students are already seeing several major changes in their health care coverage. The Patient Protection and Affordable Care Act, which was effective Sept. 23, 2010, ushered in several new benefits for college students.
Following are five ways that the new health care reform law affects young people enrolled in colleges and universities:
On-campus health plans will improve
The new law requiring that all on-campus insurance plans have a medical loss ratio that is at least 80 to 85 percent (depending on the plan’s size) became effective January 1, 2011. This means that at a minimum, 80 to 85 percent of all premiums paid by policyholders must be used for medical care. Students and their parents have long complained about insufficient coverage and with good reason; prior to the new law, some college health plans had a medical loss ratio as low as 50 percent.
The new law requiring that all on-campus insurance plans have a medical loss ratio that is at least 80 to 85 percent (depending on the plan’s size) became effective January 1, 2011. This means that at a minimum, 80 to 85 percent of all premiums paid by policyholders must be used for medical care. Students and their parents have long complained about insufficient coverage and with good reason; prior to the new law, some college health plans had a medical loss ratio as low as 50 percent.
Extended insurance coverage
College graduates are now able to stay on their parents’ insurance until they are age 26. Students can receive years of extended insurance at less expensive rates as they continue their education or start careers.
Comparison shopping for the best plan in 2014
Students who are enrolled in a college or university in 2014 will be able to take advantage of a new health care reform law that will become effective that year. In 2014, all consumers (college students included) will have the ability to compare different health insurance policies for affordability and purchase a plan that best meets their needs.
Lifetime caps for student coverage are eliminated
Students will no longer have to make the tough decisions about when to seek medical attention out of fear of exceeding their lifetime cap for coverage. No insurance plan can place lifetime limits on health coverage, which means that no one can be told that the medical costs associated with a long-term or catastrophic medical event or condition is too much for the insurance company to cover.
Health Care Reform Takes Some Stress off Job Seekers
Finding a job is stressful enough for new college graduates, particularly in a market where new job creation is sluggish. However, for those recent graduates who are fortunate enough to find a job, companies with at least 50 employees are now required to provide health insurance to all workers. Employees who earn $88,000 or less a year will be eligible to receive some subsidies.
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Public Plan
What it Means: A government-run health plan that would compete with private plans on cost.
What You Need to Know: A public plan could leverage its volume into lower costs and premiums, but critics claim it could put private insurers out of business.
What it Means: The claim that in a public plan lawmakers will decide the quantity and quality of the care you receive.
What You Need to Know: No aspects of the reform law include rationed care. There were never any plans to create rationed care.
Source: http://www.time.com
Health Care Glossary
Fee for Service
What it Means: The patient pays for medical services individually — each visit to the doctor and every test or procedure the physician orders.
What You Need to Know: This makes it hard to keep track of the total bill and in some cases, can cost the patient more money.
What You Need to Know: This makes it hard to keep track of the total bill and in some cases, can cost the patient more money.
Pre-existing Condition
What it Means: A pre-existing condition is an illness, symptom, or diagnosis an individual has before he or she takes out an insurance policy.
What You Need to Know: Some insurers take pre-existing conditions into consideration when they are deciding whether or not they will offer a policy. However, as a result of the new health care reform law, insurers will no longer be able to deny coverage or charge an individual a higher premium by citing an individual’s pre-existing condition.
Deductible
What it Means: The deductible is the amount of money patient must pay toward a medical bill before the insurance company pays.
What You Need to Know: Failure to pay the required deductible will result in the insurance company refusing to pay the medical expenses and the patient will become liable for the total amount due.
Public Plan
What it Means: A government-run health plan that would compete with private plans on cost.
What You Need to Know: A public plan could leverage its volume into lower costs and premiums, but critics claim it could put private insurers out of business.
Rationed Care
What it Means: The claim that in a public plan lawmakers will decide the quantity and quality of the care you receive.
What You Need to Know: No aspects of the reform law include rationed care. There were never any plans to create rationed care.
Source: http://www.time.com
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How Proposed Regulations Will Benefit Students
Clark Atlanta University Graduates
When parents wave goodbye to children as they head off to college, they may have one less worry if proposed regulations announced in February 2011 by the U. S. Department of Health and Human Services (HHS) are finalized.
If finalized, the regulations would take effect in 2012 and would gradually be phased into college health plans through 2014, which is the year that all provisions under the 2010 health care reform law will be in effect.
According to Young Invincibles, a Washington, D.C.-based policy research and advocacy organization that represents the interests of 18-to-34 year-olds, three million college students use college health plans but a major problem is that the benefits that they offer vary widely from plan to plan. For example, some college health plans have benefit caps, while others provide customers with poor value for their insurance premiums.
According to HHS, approximately 1,500 to 2,000 U.S. colleges and universities offer some type of health coverage but what benefits are covered by the schools’ plans as well as how they are regulated vary widely. The proposed regulation would ensure students enrolled in these plans benefit from important consumer protections created by the Affordable Care Act by clarifying that these plans will be defined as “individual health insurance coverage.”
“The proposed regulations are critical for college students because they will lay out a set of standards that will eliminate the variation in services existing among college health plans today,” said Aaron Smith, co-founder and executive director of Young Invincibles. “Another factor making regulations important is that coverage for students will be more in line with the protections now provided under the healthcare reform law signed by President Obama last year.”
The proposed regulations would ensure students enrolled in health insurance coverage through their college or university benefit from critical consumer protections created by the Affordable Care Act. This would have implications for the majority of Clark Atlanta University students.
“All full-time undergraduate students are automatically enrolled into the university’s healthcare plan and therefore, the prospect of greater consumer protection for college students would have a great impact on CAU students,” said Janet Singleton, who is CAU’s nurse and director of Student Health Services. “The Affordable Care Act gave college students much more control over their health care. The proposed legislation will provide them with another layer of protection and should give students some measure of guarantee that the plans remain accessible to them.”
Singleton also said that all residential and international students are required to purchase CAU’s plan from Student Health Services. Students falling outside of the categories of full-time, residential or international have the option of purchasing the insurance and can do so by contacting Student Health Service.
Currently, many health plans for college students only offer limited benefits with low annual dollar limits on health care. In some cases, they have a limited number of doctors who are part of the networks and other health care providers. For many students, including Clark Atlanta students, these health plans are their only health insurance option.
Under the proposed regulations, student health insurance plans would be allowed to have annual dollar limits on essential health benefits of no less than $100,000 for policy years beginning before September 23, 2012. Student health plans with policy years beginning after that date must fully comply with the Affordable Care Act’s annual limit restrictions.
New regulations would also generate greater transparency of the health care plan process by requiring insurance companies to clearly tell students enrolled in student health plans whether or not their plan meets the new requirements under the Affordable Care Act.
Transparency and other changes under the new regulations would will aid college students in better understanding the value and quality of their healthcare coverage and also give them more control over important decisions regarding their healthcare.
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Answers to Students' Compelling Questions
Myth 4: Health care reform will raise taxes.
Fact: Only those people earning more than $200,000 individually ($250,000 as a married couple) and those with high-premium insurance plans will see tax increases.
Myth 5: Health care reform will create nationalized health care.
Fact: The bill calls for creating the state-based American Health Benefit Exchanges and Small Business Health Options Program Exchanges – not nationalized health care. These exchanges will include private insurance options and will be administered by a governmental agency or non-profit organization. Individuals and small businesses up to 100 people will be able to purchase insurance through these exchanges. Insurance companies will compete for business on these exchanges.
Myth 6: Health care reform will be the start of socialized medicine.
Fact: At no time during the recent health care reform discussion did anyone suggest that the U.S. develop a system of socialized medicine in which the government finances and provides health care services. Under health care reform, not only will you get your care from private doctors, you'll get your insurance from a private insurance company.
Myth 7: You won't have any choices under health care reform.
Fact: While your choices won't be limitless, you will likely have more comprehensive coverage than you do now if you are under an individual plan. Your employer plan choices will likely remain the same or your employer may switch insurance companies, but that will still be the choice your employer can make.
I am young and healthy. Why do I need health insurance?
Despite your age and health, you never know when a serious injury or illness will strike. An accident or sudden illness can happen at any time, and if you don't have insurance, who will pay your medical expenses? It only takes one incident to rack up thousands of dollars in medical bills. In some cases, a single injury or illness can have catastrophic costs. Insurance gives you the peace of mind that most of your medical bills will be covered in case something happens.
There are government assistance programs out there; won’t they pay my medical bills.
There are assistance programs available to uninsured students but most have strict income guidelines that you must meet before becoming eligible for help. Some programs will only provide help for certain services.
Suppose I get sick or hurt? Doctors and hospitals will treat me, won’t they?
Yes, most doctors and hospitals will provide you with medical treatment you, however, the fact is they will aggressively pursue collection of your unpaid medical bills by turning your account over to a collection agency. This could have several implications such as ruined credit and these days, bad credit can keep you from getting a job, an apartment, a home or an automobile. Yes, some hospitals write off a certain amount of care each year (indigent care) but if you fail or your family fails to meet strict requirements, doctors and hospitals will pursue you to collect money owed to them.
A "co-payment" is a specific out-of-pocket dollar amount which you must pay to a provider at the time of service. "Co-insurance" is a percentage of covered expenses which you must pay: such as your insurance will pay 80 percent of a bill, and you will pay 20 percent.
An “exclusion” is a service that your policy will not cover, which means that you will have to pay the full amount of medical care out of pocket.
A pre-existing condition is an illness, symptom, or diagnosis you had before you took out the policy. Some policies will never cover pre-existing conditions, while others will consider the condition after a waiting period.
The new healthcare reform bill, signed into law by President Barack Obama early last year, will make it illegal for an insurer to deny coverage to a person because he or she has a pre-existing condition.
Source: United Healthcare Student Resources, Clark Atlanta University’s insurance carrier
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The Great Truths about Health Care Reform and What They Mean to You
It may be a cliché but knowledge is power and having accurate information not only empowers individuals but also gives them the means to make informed decisions and reduce the opportunity for costly errors.
There was so much information swirling around in the months preceding and following the new health care law, many people were misinformed about a wide range of topics related to reform.
Although 16 months have passed since the bill became law, some of the more common myths persists.
Following is a closer look at some of the more common myths and facts about health care reform:
Myth 1: Your health care will be rationed when the bill becomes law.
Fact: The health care reform bill actually will help prevent rationing by making it illegal for a company to drop customers just because they become ill and file a claim, a practice in which many insurers engaged for years because there was no law in place to stop it. Under the new law, the only way a customer can now be dropped is in those cases where the insurance company can prove fraud.
Fact: The health care reform bill actually will help prevent rationing by making it illegal for a company to drop customers just because they become ill and file a claim, a practice in which many insurers engaged for years because there was no law in place to stop it. Under the new law, the only way a customer can now be dropped is in those cases where the insurance company can prove fraud.
Myth 2: Insurers can still deny a policy to people with certain pre-existing conditions, even under the new law.
Fact: Beginning in 2014, insurance companies will not be able to deny you coverage because of pre-existing conditions. Beginning 90 days after President Obama signed the bill into law, people with pre-existing conditions were able to get health insurance through temporary insurance pools.
Myth 3: The health care bill provides for "euthanasia" or death panels.
Fact: At no time in the process were death panels or "euthanasia" mandated by the House or the Senate or even discussed as a possibility by congress.
Fact: At no time in the process were death panels or "euthanasia" mandated by the House or the Senate or even discussed as a possibility by congress.
Myth 4: Health care reform will raise taxes.
Fact: Only those people earning more than $200,000 individually ($250,000 as a married couple) and those with high-premium insurance plans will see tax increases.
Myth 5: Health care reform will create nationalized health care.
Fact: The bill calls for creating the state-based American Health Benefit Exchanges and Small Business Health Options Program Exchanges – not nationalized health care. These exchanges will include private insurance options and will be administered by a governmental agency or non-profit organization. Individuals and small businesses up to 100 people will be able to purchase insurance through these exchanges. Insurance companies will compete for business on these exchanges.
Myth 6: Health care reform will be the start of socialized medicine.
Fact: At no time during the recent health care reform discussion did anyone suggest that the U.S. develop a system of socialized medicine in which the government finances and provides health care services. Under health care reform, not only will you get your care from private doctors, you'll get your insurance from a private insurance company.
Myth 7: You won't have any choices under health care reform.
Fact: While your choices won't be limitless, you will likely have more comprehensive coverage than you do now if you are under an individual plan. Your employer plan choices will likely remain the same or your employer may switch insurance companies, but that will still be the choice your employer can make.
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Important Information for Parents Ensuring Your College Student is Adequately Covered
The primary purpose of student health insurance is to keep students in school so they can graduate and realize their professional and career dreams. Student health plans like those provided to CAU students by its insurance provider are custom designed to meet the needs of colleges and their students, and most plans are tailored around the school’s student health center.
Employer-provided insurance may not provide adequate coverage for a child in college. If your child is attending an out-of-state school, your employer provided PPO may consider the health care providers in that state out of network, which will increase your out-of-pocket costs. An HMO plan may consider those same providers as being out of their service area.
Depending upon your employer-provided plan, your child may “fall off” the plan as a dependent when they reach age 19, 21 or 23. Benefits may stop even earlier if their student status changes from full time to part time.
Why Student Health Insurance May Cost Less
Student health insurance often is less expensive than traditional health insurance programs for reasons that include:
- Many student health centers provide deep discounts if care is provided on campus. For this reason, student health insurance plans don’t need to be as comprehensive as traditional plans.
- When students complete their education, they are no longer eligible for student health insurance, which means that most participants are only enrolled for a limited, relatively short period of time. Actuaries point out that the longer a person stays enrolled in a particular health insurance pool, the more health care he or she will require.
- College students are younger and typically healthier than the general population, resulting in reduced risk for the insurer. However, because illness or accidents can happen at any time, insurance rates typically reflect that reduced risk.
The advantages of student health insurance make them an affordable, quality alternative to more expensive, more comprehensive traditional plans.
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How CAU’s Student Health Services Extends
Health Care to Students with Outside Insurance
Health Care to Students with Outside Insurance
Janet Singleton, nurse for Clark Atlanta University and director of Student Health Services offered the following information to students seeking health care services. The information applies to students whether they are insured the university’s insurance company United Healthcare Student Resources, insured by another company or whether they currently have no insurance.
Students are not required to have insurance to receive services from the CAU’s Student Health Services. Students pay a health fee which allows them to receive free unlimited services from the health center. Students are not billed for their visits.
All medications and supplies are provided to students without a charge. However, students requesting laboratory (lab) services (i.e., pap smears, blood work) that must be sent to an outside lab will be billed by the lab company. CAU is currently contracted with Quest Diagnostics.
When the lab order is placed in the computer, the student’s insurance information is used at that time. If the student does not have primary insurance, the school’s insurance is used.
Students without insurance coverage may elect to be billed directly by the lab.
If a student’s primary insurance carrier denies a claim to cover their lab costs, students are encouraged to file a claim with the school’s plan, if they are enrolled in the plan.
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