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Mandate to affect student health care

Published: Wednesday, July 4, 2012

Updated: Wednesday, July 25, 2012 21:07

The U.S. Supreme Court largely upheld President Barack Obama's health care reform bill, the Patient Protection and Affordable Care Act requiring most Americans to purchase heath care.


Most students, whether under their parent's insurance, self- or uninsured, fall under the umbrella of people to be affected by the new health care law.


According to the Affordable Care Act,  those who don't comply with the mandate must make a "shared responsibility payment," according to Chief Justice John Roberts' written majority opinion.


Roberts said the Court could not uphold the "individual mandate" under the premise of Congress' power to "regulate commerce." In other words, the Court said Congress can't force someone to purchase a product. But the Court could enact the bill if the mandate is construed as a "tax" — instead of a "penalty" — based on Congress' power to "lay and collect taxes."



How will ACA affect students?

About 30 percent of Texas A&M University students currently do not have health insurance.


President of the Health Science Center Dr. Nancy Dickey said most of those students will be included in the mandate.


"I think we could anticipate that more college students are likely to be insured by 2014 than currently," she said.


Dickey said there is a possibility the University wouldn't need to charge students with a health fee, because if students are getting primary care through the means of required health insurance, they may not need Student Health Services.


She said the student-paid health fee, which was $72.50 per semester last year, is unlikely to increase as a result of the ACA because students receive primary care that is covered by said fee.


Under the new law, people up to 26 years of age — married or unmarried — are covered under their parent's insurance, instead of the previous law which covered 25-year-olds and younger on their parent's insurance.


"If [a] student does not have insurance through their parents … only time will tell if the student chooses to take advantage of the opportunity to buy the insurance — presumably with the help of subsidies since their income will be low — or will chose to pay the tax," Dr. Barbara Tyler said.


She said the tax will be a small amount because it is relative to a percentage of income.


Dickey said some of those in the medical community speculate the ACA will drive the best and brightest students to professions other than medicine, but during her time at the HSC there has been an increase in number and quality of applications.


"Most people don't go into medicine based on finances … most people go into medicine because they like the opportunity to help people and be involved in a science that changes literally on a daily and weekly basis," she said.


Senior psychology and forensic and investigative sciences major Tommy Lau said he isn't going into medicine for financial reasons.


"I wanted to go into the medical field because I want to bring a sense of relief to the family of a patient and be able to give them more time to create special memories," Lau said.


Dickey said part of the HSC's obligation will be to educate incoming students on how to influence health care system and the government.


"The [ACA] is not a perfect bill," she said. "There are lots of things that need to be modified, changed, added, taken away, and the Supreme Court decision the other day was just one step in literally hundreds if not thousands of steps that will dictate how health care is provided in this country over the next 25 years."



The cost of care

Some people predict administering the ACA will increase the cost of care. Dickey said that is one philosophy.


Another prediction is that the 30 million people currently without health insurance, who will now be added to the system, will increase the cost of providing health care due to increased demand, but only temporarily. Once people receive preventative care and there are subsequently less chronic illness cases, the cost is predicted to go down, Dickey said.


"The cost ought to come back down because it's easier to treat hypertension and control it than for that person to go untreated, have a stroke and have to support them in rehabilitation," she said. "In the short term the cost will be perceived to go up."


Tyler said she questions the requirement that employers provide their employees with health care under the ACA.


"In theory I think this is a great idea. I am concerned, with the current state of the economy and the level of unemployment, that this will be a burden on some of the companies that are barely profitable now," Tyler said. "Will we see reductions in force to offset the mandated insurance coverage?"


If the cost of care goes up, and therefore insurance goes up, it may be cheaper for an employer to pay the penalty rather than insure its employees, Dickey said.


"If that drives more and more less-generous insurance plans then reimbursement to physicians, hospitals and others may go down," she said.

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