For most twenty-year olds, matters of healthcare have fallen to their parents. Many students are covered by their parents’ insurance plans, and have been for their entire lives; most others still rely on their parents to foot the bill when health problems arise. President Obama’s Affordable Care Act, colloquially known as “Obamacare,” mandated that individuals could remain on their parents’ plans until age twenty six. As a result, many college students are covered for the foreseeable future, and some will continue to think of healthcare as something to worry about farther down the road.

However, several parts of Obamacare are relevant to college students today, even those who remain enrolled in their parents’ insurance plans. The first of these is the aforementioned change in eligibility rules. In previous years, children were ineligible to receive coverage under their parents’ plan after age 18, 19 or 21, depending on their insurance company and policy, and had to purchase their own plan. Today, individuals can remain covered by their parents’ plan until age 26. Dr. Merrill Miller, Colgate’s head physician, estimated that roughly two-thirds of Colgate’s student body receives healthcare through private family plans.

The second important aspect of Obamacare is the notion of “pre-existing conditions.” Colgate students are required to have health insurance. Since some out-of-state health providers do not extend their coverage to the Hamilton area, a substantial portion of students enroll in Colgate’s Student Health Insurance Plan.

In the past, students with pre-existing conditions, such as disabilities or already-diagnoses illnesses, could be denied coverage on private health plans because insurance companies have little incentive to cover individuals who are already known to require healthcare. The Affordable Care Act declared that insurance companies could not deny coverage to individuals based on these pre-existing conditions, and students who arrive at Colgate today with such conditions are guaranteed eligibility.

Third, the ACA mandated that a wide array of preventative services must be available to those with any health insurance. These services are unrelated to specific injury or illness, and instead cover a range of general health problems; the National Association of Student Personnel Administrators, a national foundation dedicated to studying and improving student affairs at U.S. universities, released a report in July 2013 that listed most of the relevant services that must be available to students: “women’s healthcare, alcohol screening and counseling, depression screening and counseling, STD screening…PAP tests, HIV tests, contraception and more were added in 2012.” A wide range of immunizations are also part of this package.

Lastly, the ACA removed “upper limits,” on insurance plans. This means that insurance companies cannot provide coverage which is, for example, limited to $500,000. Insurance companies must cover individuals for the duration of their treatment, and cannot leave clients uninsured once a certain amount of money has been spent.

Miller, who classified these four changes as “wonderful,” said that many of these changes had already been made at Colgate before Obamacare went into effect. For instance, well before the ACA was implemented, Colgate had established clauses in its student insurance plan that covered immunizations and pre-existing conditions. She also cautioned that much of the negative press surrounding Obamacare centers around the idea that some individuals pay more for insurance today than they did before the ACA went into effect.

“[Obamacare has] raised the minimal standards of healthcare in the United States. People pay more because their previous plans covered very little and didn’t meet these higher standards,” Miller said.

 In other words, individuals who paid very little money for very little insurance are now paying more, because insurance companies must offer better, more complete policies, which cost more money; the weakest or least complete insurance plans are now obsolete.

To Miller, this is a good tradeoff. In her mind, the cost of one year of health insurance through Colgate ($834 in 2013, according to the Gallagher Koster website) is well worth the cost; in particular, she said, international students are all enrolled in the school’s student coverage and receive excellent care.

However, Miller also mentioned that the care offered to international students is inferior to the care they receive in their home country if that country has a universal healthcare program, like those found in most of Europe, and particularly in Scandinavia. In this light, despite her praise for the higher standards mandated by the ACA, Obamacare still has room to improve.

Obamacare has improved the requisite standards of healthcare in the U.S. and has increased the number of healthcare options available to young adults. Students can choose between school student health plans, private insurance plans, plans from federal or state exchanges or Medicaid as the ACA also expanded the eligibility requirements for Medicaid.

The NASPA report concluded that “most students under 400 percent of the federal poverty level will be insured through Medicaid or a state/federal exchange, while students with greater financial resources likely will be covered by a parental policy or a campus-sponsored student health insurance plan.”

Contact Crozer Connor at [email protected].