@deancplong: Alex, a few weeks ago, you brought concerns about changes to graduate student health insurance policies to my attention. The implementation of the Affordable Care Act (ACA), together with increased usage of the existing plan, have resulted in a projected increase in health care costs for graduate students in 2014-15.
Prompted by your concerns, I have looked into the situation further, so let me start with some of what I discovered. The actual cost of graduate student plan last year was 105% of the insurance premiums received. Normal usage is up to 80% of the level to which the plan is funded. As a result, even with no changes due to the ACA, premium rates set by Aetna would have increased in 2015 by a minimum of 30% based upon the usage of the benefits.
According to a March 26th memo from Jean Vasilatos-Younken, Interim Dean of the Graduate School, although the new plan will be more comprehensive, Aetna (Penn State’s student medical plan insurer) has projected an increase to premiums of 30%, an increase to deductibles (from $75 to $250 for individuals; from $225 to $500 for families), a reduction in coverage from 100% to 90% for in-network service (with an out-of-pocket max. of $1350 for individuals and $2700 for families), and the adoption of a $150 co-pay for emergency room visits (which is waived if the individual is admitted to the hospital).
Students are understandably concerned about these changes, and I thought we might discuss those concerns here and open a wider conversation about possible ways to respond to the situation.
Alex Feldman (Graduate Student in Philosophy): Thank you for inviting me to contribute. I think the major concern right now for us is to ensure that our voices are heard in the decision-making processes, that administrators and insurance representatives understand our situation, and that whatever decision is made is fully transparent.
Graduate students did not receive any form of notification about the proposed changes to their plan until February 25 of this year. They did not have a chance to discuss the changes with administrators until March 27.
The changes have been presented to us as largely inevitable consequences of the Affordable Care Act (ACA, aka “Obamacare”). Without getting into the technicalities of the law, I would just like to say that graduate students need a better explanation than the one we have effectively received: that our current plan is too good to be legal under the new law. “Large group plans,” for example, are not subject to the same legal requirements that Aetna is using to justify our benefits reduction. (Harvard Pilgrim Healthcare has a good fact sheet on this.) We would like to make sure that the university is actively considering all options for graduate insurance.
@deancplong: I think it is critical for graduate student voices to be heard and for the process to be as transparent as possible, which is why I appreciate your willingness to engage in this public discussion here on the blog.
The proposed changes to the health plan for graduate students certainly caught me off guard and from what I can tell, the proposed increases were not anticipated by the upper administration either. Dean Vasilatos-Younken has told me that we now have a third-party consultant looking at the plan to assess if what Aetna has projected is really required by the ACA. If it is, the consultant will help us look into how best to address the situation under those constraints. So it is not just the graduate students who are looking for a better explanation about the impact of the implementation of the ACA.
Alex Feldman: Yes, I understand that insurance companies are using the ACA nationally to justify increased costs for many vulnerable groups. The Centre Daily Times, for example, recently reported on the effects of the ACA for rural residents. I urge the university to enter into dialogue with other groups affected by the law and to advocate on behalf of all members of the Penn State community.
@deancplong: I know the university is trying to address this issue with a wide swath of faculty, students and staff. With regard to graduate assistants, the university has said that the University contribution for plans that cover family members will be increased to 75% (up from 70%) for plans that cover a spouse/domestic partner or children, and to 76% for the family plan (up from 70%). They have also agreed to maintain the current 80% subsidy for individual plans.
Alex Feldman: Yes, I read about that, but this solution would leave out the thousands of graduate students who are not currently subsidized by the university. A better solution, in my opinion, would be to extend a cost-offsetting subsidy to all graduate students, regardless of whether they are on assistantships or fellowships. Administrators at the March 27 meeting suggested a 3% raise, but it is not clear how helpful this amount would be after increased taxes and inflation. If the university does want to pursue stipend raises as a solution, I would urge them to give a flat amount to all graduate students, rather than a percentage-based raise, which disproportionately benefits those at the top while doing little for those most in need.
@deancplong: The March 26th memo did mention the possibility of a 3% raise, which I took to be a very good development considering that faculty and staff rarely see raises as high as 3% in a year. I understand that this increase, together with the increased University contribution to the higher cost plans, will offset the anticipated increase in monthly premiums for all graduate students. (I have some examples that I’ll post in the comments.)
Still, your point is well taken that we need to consider how to ensure that those who are most in need of help receive it. My understanding is that a Task Force is being established to investigate other options to address those additional needs.
There are a number of other issues at stake here as well, including the question of how to ensure a “living wage” for graduate students. Perhaps we could take that up in a separate post but open it up here for the thoughts and ideas of those who may be following along with us.
What concerns do you have about the changes to graduate healthcare coverage? What suggestions do you have to effectively address the situation? How can we further facilitate thoughtful discussion about this issue?