Components of the Patient Protection and Affordable Care Act took effect yesterday, but their impact on student health insurance remains unclear. College officials are still discussing what exactly the how the act will change the current policy.
"There's a lot of back and forth right now and I just don't know," said Director of Health Services Sandra Hayes of the debate over how the act will affect student health insurance.
"The issue of student health insurance and its status is a big question mark after health care reform, and I think there may be some changes in what needs to be offered," said Senior Vice President for Finance and Administration & Treasurer Katy Longley. "My guess is we're going to have to increase coverage."
The College's insurance plan, however, will not change this year as it signed up for another academic year of Gallagher Koster's Student Accident & Sickness Insurance Plan before yesterday's rules were released.
"Right now our health insurance plan, we're on from August 15, 2010 to August 14 at midnight, 2011, so I don't see any change from first semester to the second semester at all," said Hayes.
According to Hayes, the College will reevaluate the plan in April after talking to the health directors of peer and national schools. These directors, Hayes included, are already in communication on the American College Health Association's listserv regarding the act.
"There's a lot of information and debate on that listserv about if that plan is going to be the only plan, so that there wouldn't be an additional accident and health plan," said Hayes.
"If the Bowdoin accident and health plan stays, then things won't change and if that goes away, it will affect referrals, but I'm not sure in what way or what students might be affected most," Hayes continued.
This year, 497 students were enrolled in Gallagher Koster's plan while 507 students were last year.
"Bowdoin is called a hard waiver school, so you are signed up for health insurance unless you fill out a waiver declining the insurance," said Hayes. "At Bowdoin, you have to have health insurance. Other places don't have that requirement."
While the act's impact on student care is unknown at the moment, its effect on employee insurance is clear. On January 1, 2011, the College's coverage for employees will change in three ways.
First, the children of employees will be covered until they are 26 years old, regardless of status. Under the College's current plan, children are covered until age 25 if they are full-time students.
"Now, the student [status requirement] is removed and the age is increased," said Longley. "The child does not have to be living at home, they can be married or unmarried, so it's really not a dependent anymore—it's pretty broad. That's probably the biggest change."
The second impact on employee coverage will be the changes made to flexible spending accounts.
"The other big change happening January 1, 2011 is that the types of expenditures you can be reimbursed for under [Flexible Spending Account] change, and over-the-counter drugs are no longer reimbursable," said Longley. "We have flexible spending accounts...which allow you to put away money pre-taxed to cover health and medical expenses that may not be covered by the health insurance plan."
Longley gave the hypothetical example that if her eye doctor was covered, but her contact lenses were not, she "could take that amount and be reimbursed pre-tax."
"The other thing that is going away is lifetime maximum benefits," said Longley. "We had a maximum benefit of $3 million under our plan, and as of January 1, 2011, there is no maximum."
Given the increases in coverage, Longley said that costs are likely to go up.
"Our plan will cover more conditions and more people—for example, the coverage for dependent children—so we would be nave to think that higher costs won't result," she said. "So there will clearly be higher costs to the College and to employees. We can't quantify what those are going to be, but when you expand coverage, typically there's a concurrent cost increase."
This increase will be smaller than those experienced by institutions with leaner plans than Bowdoin, whose plan already covers much of what is mandated by the new act.
"The one thing about our plan, is that we actually already cover many of the things that were included in [the act], and so we're rather fortunate," said Director of Human Resources Tama Spoerri.
"A lot of the other provisions of health care reform, they were already in Bowdoin's plan," said Longley. "So for instance, we can't exclude preexisting conditions. That was a big deal in health care reform...but it's already in Bowdoin's plan, so if you're an employee or you're a new employee or you have a child that's coming under the plan and has a preexisting condition, we cover them."
While some colleges and universities may see costs rise by as much as 15 percent by 2014 when the law will be fully in effect, Bowdoin is not likely to see such a dramatic increase.
"The College has a very generous plan already, so we don't think it will be 15 percent," said Longley.
Any increase, however, is regrettable, said Longley, as the College has been working hard to keep down costs.
"It's unfortunate because...we've frozen salaries, we've been trying to moderate tuition increases, so to have health care costs at this time—health care cost increases are nothing we look forward to," said Longley.
"As far as January 1, 2011, we expect a modest increase similar to the types of increases we've had in prior years, which have been in the 3 to 5 percent range," she added.
This article has been changed since its original publish date for correctness.