State wants college students to get health insurance

by Lesley Politi on December 4, 2008

If Daniel O’Neill had his way, he wouldn’t have health insurance.

Since getting married last summer — and booted off his parents’ plan — the Brigham Young University junior has had to juggle premiums with tuition and books, room and board and other expenses. The 23-year-old, who seldom sees a doctor, has a hard time justifying the expense.

“I would consider myself healthy,” O’Neill said, “which is kind of why I wouldn’t normally (have health insurance) because I figure I’d never use it anyway.”

It’s the reason the Y., since 1989, has required students like O’Neill to have it. Whether through their parents, a spouse or the school, health insurance keeps students in better health — and in the classroom — and means the community doesn’t have to bear the expense of their care, said Todd Hollingstead, a Y. spokesman.

With health care reform high on his agenda, Gov. Jon Huntsman Jr. is interested in requiring all higher education students to get insured — an idea that has the enthusiastic support of some of the state’s largest institutions and their students.

In Utah, the uninsured rate is highest among the 18 to 34 age group — at 17.8 percent, according to the 2008 Utah Healthcare Access Survey. Among the students in that group, only a small percentage can’t afford it, said Jim Davis, a physician and director of Utah State University’s Student Health and Wellness Center. Most just simply don’t see the need for it.

While it’s true younger people tend to be healthier, they’re also more prone to traumatic injury and death. A report by the Utah Department of Health’s Violence and Injury Prevention Program shows the highest number of hospitalizations and ER visits occur among those ages 15 to 24. “There is a concept of invulnerability, but in reality there’s not one of them who is safe,” Davis said.


When these uninsured youth show up with head injuries, broken bones or illnesses left unattended too long, the hospitals — and ultimately those with health insurance — get stuck with the bill. This kind of cost shifting inflates everyone’s premiums to the tune of 17 percent, Greg Poulson, an Intermountain Healthcare vice president, told the Legislature’s Health System Reform Task Force earlier this year.

John T. Nielsen, the governor’s advisor on health care, said plans to design a low-cost health insurance plan for students is in the works and could be presented to the Legislature as early as this upcoming session.

“It would be a product design that would certainly eliminate state mandates [for certain coverage areas] and have a very narrow network,” he said, and would cover four to five types of care “that are essential to make insurance really insurance.”

Making good use of existing student health centers — and in areas where those don’t exist, contracting with local providers to create networks — would also likely be part of the solution, “all of this moving toward some kind of omnibus requirement (for health insurance),” Nielsen said.

Whether such a requirement would be implemented by the Legislature or the Utah State Board of Regents, however, is unclear.

“The (Board of Regents), as I understand it, prefers to do it through a regulation and not a law,” said Utah Department of Health Director David Sundwall, “and if it accomplishes it that way, that’s fine with me.”

For a student health insurance mandate to work, every public school would have to participate — a lesson the University of Utah learned in the mid-1990s, when it started to mandate coverage as part of a three-year plan, said Kerry Hill, the U.’s student health insurance manager.

Competitors like USU moved in, renting billboard space near the campus and advertising a cheaper education that didn’t require health coverage. The U.’s interim president, as a result, dropped the requirement — even though the larger risk pool had allowed the insurance plan to offer benefits such as prescription drug coverage while lowering students’ premiums by 20 percent.

Now the U., where between 16 and 20 percent of students are uninsured, offers a plan that costs $1,326 for the school year — about three times as much as the one at the Y. “It’s really people on a voluntary plan who are sick,” Hill said. “They buy it because it’s the only insurance they could get, basically.”

The U.’s student health advisory committee tried to bring back the requirement. “But that just wasn’t possible because of an administration that couldn’t back that up for us,” Hill said.

USU’s Davis said requiring students to get insured is an easy way to swiftly slash premiums, which in turns improves access to health care. USU students — 19 percent of whom are uninsured — support it. “It seems to be a no brainer,” said Davis, who earlier this year circulated a white paper in support of a mandate.

O’Neill, who would prefer not to have insurance, admits that because he’s required to have it, he is more likely to go to the doctor. He recently made an appointment to be seen for a sore throat.

And, the information systems major said, the Y.’s plan is affordable: $204 per semester, with $10 copayments and no deductible. He pays for it with some of his low-interest student loan.

“The only way to get (a health plan) cheaper than the one the university provides is to have a pretty high deductible,” he said, “which would pretty much make it worthless anyway.”


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