College Students Coaxed Towards Health Insurance


When it comes to the Affordable Care Act, even college students who are in the business of being educated still have some questions about it. The California State University system has created a health insurance education project, enlisting teams at many of the campuses across the state to help inform college students, their families and part-time employees about the new online insurance marketplace,

At California State University, Monterey Bay, the Institute for Community Collaborative Studies started outreach this fall in Monterey and Santa Cruz counties. The team has done outreach at CSUMB as well as Cabrillo Community College and other community events.

“A lot of people are just unaware of the new program as a whole,” said Emma Spellman, a research assistant with ICCS and a project coordinator for the outreach project. “There is a lot of confusion about eligibility. A lot just assume they are not going to be eligible because they have been uninsured for so long.”

As part of their outreach efforts, Spellman and others have helped people use the calculator tool on the Covered California website to see what their estimated premiums might be. The premiums are based on income as well as the type of coverage an individual or family selects – some plans have lower premiums in exchange for higher deductibles will others have higher premiums in exchange for no deductible.

“Everyone kind of assumes college kids and young people think they are invincible and don’t want insurance,” Spellman said. “But those who don’t have it don’t have it because of the cost associated with it. It has been so unaffordable.”

As the last parts of federal health-care reform, known as the Affordable Care Act, are rolled out in 2014, the federal government has expanded the income level for people to qualify for free health insurance that is provided in California under Medi-Cal. Other changes allow individuals or families to qualify for a subsidy to help cover the cost of medical premiums through the health care exchange. Covered California has a variety of health-care options available, including Kaiser Permanente, Blue Shield and more. Families or individuals who have employer-based health insurance will have the option to stay with their insurance or move to the health-care exchange if they can find a more affordable plan, though they won’t be eligible for subsidies if their employer provides coverage.

“Health insurance isn’t very glamorous,” Spellman said. “It is a subject that is hard to get college students excited about – it is not the most exciting or most thrilling. But those who need it are definitely interested.”

At San Jose State University, an urban campus that has a large percentage of commuter students, the Health Insurance Education Program team has been visiting classrooms to reach students about health insurance as well as a series of informational sessions open to the campus and community.

Van Nguyen, a master’s of public health student in the College of Applied Sciences and Arts, said the HIEP team has been averaging three classroom visits a week. Nguyen, her MPH classmate Keri Simmons, and instructor Anji Buckner, created a slideshow presentation that can be tailored down from 30 minutes to 10 minutes to meet the needs of busy students.

Nguyen said the main question her group has been getting from students is how financial aid might impact their eligibility for subsidized health insurance. They’ve explained to students that while student loans will not be counted as income toward eligibility, grants will be factored in as income. For students who need more specific information on their eligibility, the SJSU team has cards and fliers ready with the Covered California website and call center numbers.

“Most of the students seem also to want to get their families involved,” Nguyen said.

College students are one of the largest uninsured groups in the state of California, according to CSU HIEP. Simmons said the main reasons college students were not already enrolled in health insurance is due to pre-existing conditions, because they are not eligible for health insurance through employers because they work part-time jobs, and due to the expense of enrolling in an individual insurance plan.

Simmons stressed that with health-care reform all those barriers for students have been removed.

As with the students at CSUMB, the San Jose team found that most college students who do not have health insurance have family members who are also uninsured.

From their first few meetings in classrooms, Nguyen and Simmons created a FAQ for their slideshow presentations with the most commonly asked questions. They explained that while the students pay a student health center fee, that fee is not the same as health insurance.

“You can receive primary care, but it is not for emergencies,” Nguyen said, explaining that an injury such as a broken leg could have a student saddled with medical bills that total as much as a semester’s tuition.

Spellman said she had come up against a little bit of hostility in Monterey County from people who are against health-care reform – a wedge issue that shut down the federal government in October – but that those sentiments had been in the minority.

“It was mostly after Oct. 1 when the Covered California [website] was not working well because of the huge influx of people,” Spellman said. “There were some frustrated individuals. We talked to them and explained the program, and calmed them down so they understand it a little more clearly.”

Spellman said the grant her group received from Covered California will allow them to continue outreach efforts through March 2014 and then again during the open enrollment period in September through December of 2014. The SJSU HIEP team will continue their efforts through March 2014.

“It is an exciting time for health-care and for this population in particular,” Spellman said. “There are big changes happening, especially for the CSU system where there was no real health insurance option for students through the school. This is a great opportunity and a really good way for them to make sure they can stay healthy and get the coverage they need.”

For more on CSU HIEP, visit

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