<<< CORRECTION: The Chair of the Department of Health Sciences is Dr. Anita Slechta, not Dr. Bethany Rainisch. Dr. Slechta was interviewed for the story, not Dr. Rainisch.
Over the three years since congress passed the Patient Protection and Affordable Care Act in 2010, changes in health care policy have made health insurance more accessible for children and young adults.
However, polls find many in this demographic are still uninsured or are unaware of how provisions under the Affordable Care Act (ACA) affect their coverage options. According to a June 2013 Gallup poll, 43 percent of uninsured Americans – a category many young adults fit into – are unaware of the mandate requiring all Americans to have health insurance starting January 2014.
Under a grant provided to the Cal State University by Covered California, the new California public health insurance exchange, the CSU Health Insurance Education project plans to educate CSU students about health care reform and how to purchase insurance once the exchange opens on Oct. 1.
According to Dr. Bethany Rainisch, Chair of the Department of Health Sciences, Covered California awarded the CSU with a $1.6 million grant for an educational campaign. The proposal was spearheaded by CSU Los Angeles’ Health Sciences department chair, Dr. Walter Zelman, supported by departments chairs of health sciences from all the CSU campuses.
Under the grant, the project provides coordinators at each CSU campus to carry out an educational campaign aimed at students. At CSUN, the coordinators are Valerie Ojeda, a graduate student studying health sciences, and Azniv Gevorkyan a graduate student studying public health. Ojeda and Gevorkyan say their mission is to outreach to students, their families and part-time staff who may not be aware of Covered California and how to purchase health insurance through it.
“The ACA is very comprehensive and large and has a lot of regulations and policies,” Ojeda said. “But we are trying to simplify it as much as we can to be able to give students the basic info they need to then seek help from the enrollment counselors. We’re providing information as to what the ACA is about and how it affects students in their age demographic.”
For example, children up to age 19 may no longer be refused or dropped by an insurance provider if they have a “pre-existing condition.”
Young adults may stay on their parent’s insurance plan up to the age of 26, instead of being covered only until age 18 or 21. Many young adults in California with lower family incomes may now qualify for Medi-Cal, government subsidized health insurance, as long as their family income does not exceed 250 percent of the federal poverty line ($58,875 for a family of four in 2013).
Preventive care is provided for no out-of-pocket cost. Most women’s preventive care, such as mammograms and cervical cancer screenings, will be provided with little to no cost-sharing. Lifetime caps on coverage by insurers have been abolished.
Rainisch said though the CSU Health Insurance Education project is present on all CSU campuses, the original health science scholars (grant writers) were originally targeting Southern California, as the CSU campuses in the area reflect the diversity in socio-economic status of the larger population.
“The majority of our students are eligible get into these exchange programs or the Medi-Cal system,” Rainisch said. “Many students don’t know they can sign up right now. Those that aren’t qualified, they can qualify for different levels of the exchanges.”
Ojeda and Gevorkyan are collaborating with faculty, different departments at the university and the student health center. Other strategies to educate CSUN students include making classroom visits and answer any questions students might have about healthcare, using social media to promote their campaign and setting up booths on campus.
“We have a largely commuter campus,” Ojeda said. “We’re having to work at various hours during the day and partner with clubs and organizations that already have their own events going to reach a wider population of our students.”
Though they aim to inform students about the new healthcare exchange, Ojeda and Gevorkyan will not actually assist students in signing up for their health plans. Instead, their goal is to inform students and direct them to the Covered California website, where students can choose from health plans they qualify for.
Students can go to the Covered California website and shop for insurance using their “calculator” web page. Options will vary based on a student’s age, household income, number of family members and age of each adult. Coverage rates vary also based on postal code, due to differences in the cost of living in various geographical locations.
There are generally four different levels of insurance that consumers can buy; Bronze, Silver, Gold and Platinum. Bronze and Silver plans charge lower monthly premiums, but higher deductibles or co-pays, while Gold and Platinum plans charge higher premiums, but require less in cost-sharing.
The last category of insurance is a bare-bones coverage plan called “Catastrophic” and is offered to consumers under the age of 30, most in for catastrophic events like car accidents. Ojeda and Gevorkyan do not encourage students to get that plan because the co-pay for a hospital stay or surgery can end up being very expensive.
All insurance providers in the health insurance exchange must offer 10 “essential benefits” in compliance with the ACA. These benefits are: ambulatory patient services; emergency services; hospitalization; maternity and newborn care mental health and substance use disorder services; including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
While students pay semester fees to access services through the Klotz Health Center, this does not qualify for insurance under the ACA, as it does not provide the 10 essential benefits. The CSU does provide optional health insurance that does qualify under the ACA and will fulfill the individual mandate starting 2014. The insurance is accessible through the CSU Healthlink website and is brokered by Wells Fargo–care is provided by Anthem Blue Cross. Separate plans are available for international and domestic students.
While student health insurance may have had higher enrollment in the past, Rainisch said that her colleagues believe that such plans will decline, especially when the health exchange opens.
According to Lisa Hannon, Vice President of Student Insurance Division at Wells Fargo, it is indeed true that the cost of CSU health care premiums have been rising and enrollment falling.
“The cost of the coverage (premium) has risen each year because the insurance company (Anthem Blue Cross) is paying more in claims (doctors’ bills) than they are collecting in premium,” Hannon said. “The enrollment has declined because the prices have risen.”
Wells Fargo is not looking to persuade students to enroll into student health care, Hannon said.
“We believe that smart consumers will enroll in the plan that best suits their needs for the best value,” Hannon said. “Some will find that balance within the exchanges and others in the private market. It is anticipated that insurance carriers will price their plans competitively with exchanges and if plans cannot be competitive they will likely no longer be offered at some point.”