The Tufts undergraduate and graduate student health insurance plans in a recent renewal process have undergone changes in line with community input that emphasized increasing coverage even if it led to cost rises.
Meanwhile, the students involved in initial negotiations on the plans have raised concerns that they were excluded from final meetings on the issue.
Student Health Organizing Coalition (SHOC) attended and participated in preliminary meetings to discuss changes to the plan, according to seniors Samuel Perrone and Haley Schwartz, SHOC organizers, but had no chance to provide input after the initial stages.
"The biggest problem we had with the process was that, while we were included in the preliminary meetings, the final negotiations between the consultant, Tufts and the insurance company were conducted privately, and as students we thought that we should have been represented at those meetings," Perrone said.
SHOC is a group originating at Tufts that seeks to bring a student voice to discussions on student health insurance.
While the students tried to be included in meetings between Senior Director of Health and Wellness Services Michelle Bowdler and Aetna Student Health — Tufts' insurance carrier — these efforts never came to fruition, Perrone said.
Bowdler, however, said that student collaboration benefited the renewal process, and she applauded students' involvement.
"It's been really nice to have [student] input because figuring out appropriate benefit levels and weighing it with costs is a challenge," Bowdler said. "What could have felt like a contentious process felt really collaborative, so I'm really impressed with them."
The final version of the undergraduate health care plan will cost $1,473 per year, a five-percent increase from last year, according to Bowdler. This constitutes a departure from last year, when the plan's price remained the same and benefits were congruently static from the previous year.
The cost increases, however, are balanced by increasing student coverage, including eliminating the pre-existing condition clause, significantly raising hospital coverage and eliminating the limit on outpatient surgery costs.
This coverage increase accompanied by a slight cost rise is partly in line with and motivated by students' input.
"We looked at the price of the plan and also students expressing an increased desire to have more coverage even if it meant prices going up," Bowdler said. "This year we were able to increase benefits substantially without prices going up very much at all."
Despite concerns about SHOC's involvement in discussions, Perrone agreed with Bowdler and expressed his overall satisfaction with the results of the renewal process.
"For what we got out of it, it was a very minimal [cost] increase, and the price Tufts students pay is very comparable to what other students pay at comparable top private universities ... That said, I think in the future we can get a lot more for our money," Perrone said.
The cost increase for the undergraduate plan exceeds that of the graduate student plan, which Bowdler explained was due to an effort to close the price gap between the two. The past price differentiation was intended to compensate for higher usage among graduate students.
One area, however, that students involved with the reforms were dissatisfied with is the new plan's prescription drug coverage, which increased by $500 to $2,000, according to Perrone.
"It's good that they increased the benefit level, but we still feel that $2,000 is pretty inadequate," Perrone said. He added that last year 75 students went above the provided $1,500 in prescription drug coverage.
Schwartz felt student input in later stages of the negotiations might have influenced the resulting plans, specifically the prescription drug coverage.
"We were kind of disappointed as to the lack of urgency in people's feelings that [prescription drug coverage] was an issue," Schwartz said. She added that there was statistical proof that students had gone over the limit in the past and did not have the means to buy necessary drugs.
The Massachusetts Division of Healthcare Finance and Policy in November released a report showing that insurance companies were making high profits from student health insurance and offering fewer benefits to students.
Since the release of the report, SHOC has been advocating for a state-provided plan for students at private institutions, while simultaneously pressing for internal reforms at Tufts.
SHOC organizers first met with Bowdler in January, Perrone said.
"Knowing that insurance companies were taking extremely high profits and were sort of exploiting the student health insurance plans, we thought we could get better benefits," Perrone said.
A recent development is the passage of the national health insurance reform bill in March, which allows students to remain on their parent's insurance plans until the age of 26.
Bowdler feels, however, that this would likely have little effect on graduate student usage rates because many other health insurance plans have high deductibles that may deter graduate students from staying on their parents' plans.
"It's really inexpensive for what it offers, so if you're on your parents' plan and it seems like a good deal because he or she gets it through work, but in order for their company to keep costs down, before you have any coverage at all you have to spend at least $1,500 out-of-pocket," Bowdler said, adding that the student plan provides coverage from the first dollar spent toward health care costs.
According to Perrone, however, private insurance plans tend to be "far superior" to the student plan offered at Tufts and that undergraduates who typically opt for the student plan — less than a third of the undergraduate population — do so because their regionally organized plans are less adequate.
While it may be premature to determine all of the effects of national health care reform on student insurance plans, costs could go up in the short run as a result of the new laws, according to Bowdler.
"What we do know is that there are certain requirements for insurance plans with health care reforms … some people think student plans may be exempt and other people don't," she said.
Perrone agreed with Bowdler in that while in the short run health care costs may be driven up, an increased risk pool will eventually drive costs down.
