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Calvin Ball and Peter Beilenson: Health reform could be boon for higher ed

Lost in all the partisan political fireworks over the fate of President Obama’s signature initiative — the Patient Protection and Affordable Care Act (PPACA) — is its potential importance in the lives of many students in institutions of higher education.

This examination is especially important within the context of the completion agenda’s reliance upon student success as well as the numerous reports linking college completion with employability. With the Supreme Court’s ruling in this case expected any day, the time for examination is now.

Most reforms included in the act don’t go into effect until 2014. However, one important aspect of the PPACA—allowing young people between the ages of 18 and 26 to stay on their parents’ health plan — has already been implemented with impressive results.

During the current economic downturn, the percentage of Americans who are insured has dropped, particularly as employment numbers have lagged. The one demographic that is running counter to this trend is — you guessed it — young adults between 18 and 26, who have actually seen a healthy jump in the rate of those who are insured.

Clearly, by making insurance more readily available, this reform helps to free many students or potential students from an additional financial burden, thus reducing a potential obstacle to their ability to attend and remain in college.

Making insurance and health care more affordable for all Americans will also help to reduce financial pressures on students, as many reforms of the health care system take effect over the next couple of years. Foremost among them are two major modifications: a) the system of individual mandates, the health care exchanges and associated subsidies; and b) the prohibition of pre-existing condition exclusions.

‘Travelocity of health care’

Under the PPACA, virtually all Americans will need to show evidence of health coverage or face a penalty enforced through the tax system. To make the confusing system of insurance more transparent, electronic insurance exchanges will be set up in each state for those who don’t get their coverage through their workplace.

Operating like the “Travelocity of health care,” upon entering your demographic and financial data, the exchange will respond with a listing of all the insurance options available. And, to make insurance more affordable, federal subsidies are available for those at 135 to 400 percent of the federal poverty level (as an example, a family of four making between $28,000 and $88,000 per year) to aid with premium payments.

Making it easier to afford required coverage will aid many students who otherwise might have had to spend much more on insurance. By providing affordable insurance to all, important preventive and primary care services will be available for almost all Americans, making it more likely that potential higher education students will be healthier and more successful in college or graduate school.

Another important component of the PPACA is the elimination of pre-existing condition exclusions. Before this reform (which goes into effect fully in 2014), anyone diagnosed with a significant health condition was often denied coverage for anything related to that condition — or if the condition was significant (read: expensive) enough, coverage was so expensive as to be unaffordable.

Since millions of young Americans have such conditions, including diabetes and asthma, this reform both helps with financial obstacles as well as ensures that necessary health care is obtained.

No lifetime caps

Lifetime caps are also banned by the act. This practice, where a limit is set by insurance companies on how much they must pay over a member’s lifetime — often $1 million — can have significant consequences for young people.

For example, let’s say a 19-year-old college student who likes to bike to school gets in an accident with a tailgating car. Even if the student was wearing a helmet, such an accident may well require months of intensive care unit and rehabilitation stays, which could easily cost $1 million. Then, for the rest of his or her life, the student must pay out-of-pocket for all health care, causing great fiscal distress.

Indeed, lifetime caps play a big role in the number of personal bankruptcies filed each year, mainly by insured individuals.

Finally, through efforts at increasing the primary care health workforce, the PPACA can provide for great opportunities for students in higher education settings. The Prevention and Public Health Fund of the act provides over $250 million to train and place more than 1,000 new primary care physicians, physician assistants and nurse practitioners. Plus, financial assistance is or has been provided by the act for aid to students for both undergraduate and graduate programs.

Thus, from providing access to needed health care to reducing financial obstacles to attending institutions of higher learning and to increasing opportunities to pursue careers in health care, the PPACA offers a surprising number of important benefits to young adults and institutions of higher education.

As a growing body of research has already revealed, positive relationships between student retention and health as well as financial aid, in a time when student success is critical to our nation’s success, recognizing the impact the PPACA could have on higher education is essential.

Calvin P. Ball is a full-time faculty member in Morgan State University’s School of Education and Urban Studies and a member of the Howard County Council. His email address is [email protected] Dr. Peter Beilenson is the Howard County health officer. His email address is [email protected]