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Health plans

The contentious national debate over health-care reform has spread into a new arena — health insurance coverage for the nation's college students.

The question is whether by 2014, the student health insurance plans offered by colleges, universities and professional schools will be defined as offering enrolled students the "minimum essential coverage" required by the health-care reform law passed last March.

Under the law, by January 2014, people who haven't purchased health insurance could face a tax penalty.

If federal regulations being written at the Department of Health and Human Services do not define college student health plans as meeting the coverage standard, students might seek health insurance outside of their universities. That could force post-secondary institutions to scrap student plans entirely since the base of customers they need to keep the plans cost-effective will drain away, says Steven Bloom, a spokesman for the American Council on Education (ACE).

In response, ACE, in cooperation with the American College Health Association and other groups is urging the Obama administration to allow student health plans to be included in the law's definition of minimum coverage requirements.

"I'm hopeful that the administration will provide regulatory guidance that ensures that colleges and universities can continue to offer these plans in a way providing good quality and affordable coverage," Bloom says.

Student health plans are especially beneficial to graduate students who have aged out of coverage under their parents' plans, and international students who must show proof of health insurance coverage to maintain their student visas, he adds.

Meanwhile, the Lookout Mountain Group, a non-partisan study group of college health and higher education officials, argues that poor quality student health plans need to improve or be eliminated, says spokesman Jim Mitchell. While the group supports the continuation of high-quality student health insurance programs, it is urging federal officials to require student health plans to meet the same coverage standards that the law requires other insurance plans to follow. If student health plan coverage can be improved, the plans might offer a better deal for students than other plans students could purchase on the open market, Mitchell says.

Another critic of student health plans is former New York Attorney General Andrew Cuomo, whose investigation found significant gaps in student health plans, such as excluding people with pre-existing conditions, offering extremely low coverage limits and not covering prescription drugs. Those limitations put students and their families at risk of facing catastrophic costs for medical care, his investigation concluded.

Whatever the verdict, it will affect the roughly 2 million students now covered by university plans. The approximately 20 percent of college students age 18 through 23 who don't have insurance will need to enroll in an insurance program by January 2014 or face tax penalties.

Some of those students may be able to enroll on a parent's plan, since the new law requires insurance companies to allow parents to carry adult children on their insurance up to age 26.

According to HHS spokesman Keith Maley, if affordable coverage is not available, individuals will be eligible for an exemption, and might be eligible for a federal subsidy to purchase coverage in the new state-based health insurance exchanges scheduled to be organized. However, what counts as "affordable" has not yet been defined, Maley says.

—C. Munsey