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Answering student questions
about mandatory health insurance
By Allison Reitz
On April 12, 2006, then-Governor of Massachusetts Mitt Romney signed legislation making health insurance mandatory for residents of Massachusetts. For seniors on the brink of graduation, this new law raises major concerns.
Heather Clow, a senior English major, explains, “When I graduate, I’m going to be asked all these questions, and people will expect me to know the answers. ‘Where are you going to go? What are you going to do? Oh, and who’s your insurance provider going to be?’”
For students daunted by the world of insurance policies, premiums and deductibles, the answer to that last question is often “I don’t know.” With the July 1 instatement of the law looming in the future, many students feel pressured to find the answer.
Senior Rosemary Larkin admits, “I’m not looking forward to choosing an insurance supplier myself. There are so many types of coverage. How am I supposed to know if I’m choosing what’s best for me?”
For students like Larkin, the act of choosing a health insurance plan is new territory.
Massachusetts already requires that “all students enrolled in institutions of higher education, taking 3/4 or more of the full-time credit load must have comprehensive health insurance,” but few students decide for themselves who will be providing that comprehensive coverage.
UMass Dartmouth makes health insurance available through AETNA on a year-to-year basis for all students. Students may opt-out of this program if they have proof of insurance, which is often provided through a parent’s insurance plan. However, once students’ full-time status ends, their insurance coverage through these providers often ends, as well.
So what do students need to know in order to survive the wild world of insurance?
Most importantly, students should know that there is some leeway. Annette Arabasz, a senior graphic design major, asks, “New graduates have enough to worry about with rent, loans and car insurance. Now we have to worry about health insurance too? The state should at least give us a grace period of a year or so to get on our feet.”
Thanks to new legislation passed under the Dependent Coverage Provision, some non-students can be declared as a dependent and continue receiving their parents’ health care benefits “up to age 26 or two years after losing dependent status according to IRS rules, whichever occurs first.” Basically, this means that new graduates can potentially be declared as a dependent on their parents for insurance coverage (depending on the coverage plan), even if they aren’t officially “dependents” on their parents’ income taxes.
Once that time as a dependent has expired, though, many students worry about mandatory insurance’s affordability. Jeff Trull, a junior civil engineering major, explains, “From what I hear, insurance is very expensive, especially if you don’t have a job that covers it for you. My parents are self-employed, and their insurance seems to be fairly expensive.”
He continued, “I believe in mandatory health insurance for all, at least from a non-financial standpoint. That is, I think that everyone should be covered in one way or another because health insurance is pretty much essential to life. But as far as the money and funding aspect of it goes, [mandatory health insurance] could be tough for some people to afford. I wonder what effect that is going to have on them.”
Junior Retha Charette agrees about the financial impact, saying, “I’m scared. My goal when I graduate is that I really, really need to find a job that gives me health insurance. Otherwise, I don’t know if I can afford it.”
The new law hopefully has an answer for student concerns about affordability. According to Section Three of the Healthcare Reform Act, the state subsidized Commonwealth Care plan includes a plan specifically for 19- to 26-year-olds. The plan covers yearly check-ups with the family doctor, as well as other basic medical needs and emergency services.
Monthly premiums for this service range from a low of $105 to a high of $205. However, the deductibles (which dictate how much of a medical bill than an individual is personally responsible for paying) range from $1,000 to $2,000 and have some students worried.
Clow questions the prices, “Do you go for the low monthly premiums and hope nothing bad happens? Or do you pay more than you can comfortably afford just in case you need hospital care?”
She adds, “Insurance is like gambling. How lucky do you feel?”
For those who share Clow’s sentiment, there may be some relief in the future. The affordability and quality of these plans is still under review by the state. The State Legislature has announced that they are currently discussing a temporary freeze on requiring health insurance for low- and moderate-income individuals and families. The final decision should be released before summer.
However, the state also offers subsidized plans based on one’s annual income, which may prove to be more affordable. According to Commonwealth Care’s “Frequently Asked Questions,” monthly premiums that range in price from $18 to $70 are available to individuals who make less than $29,400 per year.
This plan includes a $1 co-pay for generic drugs and a $3 co-pay for all other drugs, as well as for the use of emergency services in non-emergencies. Co-payment charges would be capped at $200 per calendar year.
Individuals who make over $29,400 a year must choose an insurance plan from within the Commonwealth Choice program, which is similar to Commonwealth Care but is not subsidized by the state. The Commonwealth Choice program encompasses seven insurance providers that have met the Legislature’s plan requirements: Blue Cross and Blue Shield of Massachusetts, ConnectiCare, Fallon Community Health Plan, Harvard Pilgrim Health Care, New England Health, Neighborhood Health Plan and Tufts Health Plan
So what happens to people who fail to obtain an insurance plan by July 1? The Healthcare Reform Act allows for a grace period stretching through December 31, 2007. However, beginning January 1, individuals without health insurance will face financial penalties.
Unenrolled individuals will lose their personal exemption on the state income tax, which can be worth as much as $200 per year. Also, for every month that an individual remains uninsured, they will incur penalty fines of approximately $150 per month.
Arabasz dislikes the ideas of the monthly fines and exemption loss, saying, “I think not having health insurance is punishment enough. People shouldn’t be punished for not having it, too.”
Still, she understands the need for universal health care. Arabasz explains, “It’s scary to go without insurance, I admit. But some people just don’t have a choice. Still, no one should come in to a hospital with a shattered femur and walk out with a smiley sticker and a band-aid because they can’t afford the hospital fees.”
Other students, like Larkin, are worried not only about the affordability of the new insurance plans, but also about the quality.
“I know that I’m going to get kicked off my parents’ plan once I’ve graduated, but not having that same level of coverage is scary,” Larkin says. “There are probably some services that I need, but won’t really consider the cost of until I’m paying for it myself.”
The Commonwealth Health Insurance Connector, the government agency overseeing the legislative changes, assures necessary services have been considered.
In a statement released on March 8, the Connector board emphasized that despite varying prices for plans, “all offer comprehensive coverage, including inpatient and outpatient medical care, emergency care, mental health and substance abuse services, rehabilitation services, hospice and vision care.”
Full dental coverage is not currently included in any of the plans.
University students should keep in mind that the new legislation only applies to Massachusetts residents. Out-of-state college students are not allowed to take part in the State’s insurance program unless they list Massachusetts as their primary residence. Residents who move out of Massachusetts cannot retain their insurance coverage.
For students who are Massachusetts residents, plenty of resources are available to help in answering any persisting questions.
Students can contact the state’s Health Insurance Connector board at 1-877-623-6765 (or 1-887-623-7773 for the hearing impaired). For instructions on being declared a dependent or non-IRS dependent, review the application form available at www.mass.gov/gic/forms/dependentage19andoverform.pdf.
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