The Supreme Court issued its long-awaited ruling on the Patient Protection and Affordable Care Act June 28, declaring the law constitutional with a 5-4 vote. The decision affirmed the 2010 law as constitutional; yet amidst a partisan congress, a rhetoric-filled campaign, and a nation split down the middle, the state of health care is in a fragile place. Brandeis is already finding itself in the grasp of this reform, with students questioning the the effects of the Affordable Care Act.
From 1977 to 1993 and again from 2005 to 2008, Professor Stuart Altman (HS) served as Dean of the Heller School; as interim University President from 1990-1991; and now teaches the popular Heller School of Social Policy (HSSP) core class on American Health Care. In addition, he is one of the most prolific authorities on health care in the country—
Altman has served as an advisor to President Nixon, a Medicare advisor to President Clinton, and even helped write Senator John Kerry’s health care plan in the 2004 presidential election.
According to Altman, the students most affected by the law are likely to be those from low-income families, as “these students’ families will now get subsidized private insurance.” Yet, as Altman points out, this change is made possible by another provision that will affect students from all backgrounds. “Young people can now stay on their parents private insurance until age 26. Previously, students could only stay on their families’ insurance until around age 22, or not at all in some cases.”
This window is crucial for many of today’s students: Now, there is additional time for graduates to find jobs and the means to get coverage. “With the job market as it is, recent graduates now have a transition period,” Altman said. “Most would go uninsured until it was necessary, which was a risky decision. Now, everyone must be insured.” As Altman explains, this influx of young, healthy people into the market should even out the money lost by insurance companies in insuring those with pre-existing conditions. Had the Supreme Court decided that people could not be forced to buy insurance, this would be null and void—thus making the law virtually impossible to fund.
Before the transition period and the individual mandate of the Affordable Care Act, many young adults chose to go uninsured rather than pay for private insurance. University students would often be insured through their educational institution, and in Brandeis’ case, students have had and continue to have access to the QSHIP plan. The QSHIP plan is one-year health coverage provided by the University, and, as nurse manager Diana Denning of the Brandeis health center said, the plan has long been ahead of the new federal mandates. “The Brandeis QSHIPS are PPACA compliant and Mass. state regulations (which in some ways exceed the Federal regulations) compliant,” Denning said. “It is good insurance for the money, and students can use it internationally as well.”
One change in QSHIP coverage concerns preventative care. “Under the new regulations, students should see expanded coverage for preventative care services,” Denning noted. “The prior Brandeis plans provided some coverage for ‘wellness’ services but was not as comprehensively as the PPACA requires. For example, certain immunizations must be covered by insurers now … preventative care visits are now covered at no further cost to consumers.”
According to Denning, the Brandeis QSHIPS have long been steps ahead of the Federal requirements. “PPACA requires coverage without a copay for tier one contraceptives and certain contraceptives which are not available generically. Our QSHIP plans always covered contraceptives as pharmaceuticals.” In addition, the PPACA now requires that plans do not deny those with preexisting conditions. “The Brandeis QSHIP plan has never excluded pre-existing conditions,” Denning said. “Now the Federal requirements are compliant with the Brandeis plan!”
Even on the socially liberal Brandeis campus, the Affordable Care Act does not go without controversy. Biology/HSSP major Jeffrey Katz ’15 is no stranger to the world of health care—he has worked as an EMT in two states, is currently a training officer for BEMCo, and has interned in the billing office of a home health care company. “I have dealt with government on both a state level as well as on a federal level, and in both cases the government has been slow and tedious to deal with,” Katz said. “The PPACA seeks to expand the role of government in the health insurance market, which will ultimately affect the consumer in a negative way.” Nevertheless, Katz is not completely opposed to the PPACA. “Despite my criticism of the plan, I like that children can stay on their parents health insurance until the age of 26, and I like funding into research that deems what is more and less efficient in healthcare.”