UC Set to Require Student Insurance

Cynthia Bowers spotted the ugly red body rash and knew her patient was in pain. So the UC Santa Barbara health clinic doctor advised the university senior to see a skin specialist immediately.

“She gave me a look that said, ‘Are you crazy?’ ” Bowers recalls. “She said ‘I don’t have any health insurance. I’m still paying off the $3,000 I owe the hand surgeon for sewing up my tendon last spring. If you can’t fix me, I can’t afford to get any help at all.’ ”

Bowers says campus health centers across California confront the same scenario time and again: Seeing gravely ill students who sometimes must leave school to earn enough money to pay mounting medical bills.

In a vote today to address the problem, UC regents are expected to set a national precedent by mandating that students carry health insurance if they want to attend any of the California system’s nine campuses, from San Diego to San Francisco.

The new policy, modeled after programs at the Berkeley and Santa Cruz campuses, would require students to purchase insurance that can be used locally and cover services beyond those provided in university clinics. Students would need to show proof of insurance before enrolling in classes.

University officials say the coverage is crucial. They estimate that 40% of 136,000 undergraduate students statewide are uninsured or underinsured, and that 25% of student “withdrawals” each year are for medical reasons because they are ill and can’t pay for treatment.

UC President Richard Atkinson told regents Wednesday that the UC system could offer affordable student health care through favorable groups rates, the cost of which could be included in financial aid packages.

“If the regents act favorably,” Atkinson said, “UC will be the first multi-campus system in the country to adopt a policy of mandatory student health insurance.”

Bowers, who also serves as the director of student health service at UC Santa Barbara, says such insurance requirements would provide a safety net for students and administrators.

“It’s a big-time problem,” she said. “The lack of student insurance has forced me to do things as a doctor I’d rather not do. I treated the student with the rash as best I could and luckily she got better. But that’s not good medicine.”

Many of the thousands of students without insurance subsequently face emergencies that run from sports injuries, serious falls and a bad bout of acne to such life-threatening maladies as kidney disease, cancer or AIDS.

“Even so, most kids don’t even think about insurance,” said Les Elkind, director of student health services at UC Santa Cruz. “They’re young and immortal and invulnerable. Their focus is on getting the right courses, selecting a major. . . . It’s very tough to tell a 19-year-old that they’re going to die someday and quite possibly face serious medical problems in the interim.”

Some are forced to take the no-insurance risk. Many are children of the working poor who have never had insurance and who are nonetheless ineligible for government programs such as Medi-Cal. “The way the government looks at it, you’re a student by choice,” said Bowers. “If you chose to get a job, you’d have insurance.”

Others carry family HMO policies that only pay in emergency cases and require students needing to see specialists or who require extensive tests to return home for doctor referrals.

“I’ve seen thousands of students facing the same gnawing choice,” said Claudia Covello, clinical director for university health services at UC Berkeley. “Either they disrupt their studies and fly home for immediate care or wait months for a class break. Some medical conditions don’t wait, so they’re forced to pay for their care out of pocket.”

Berkeley students voted in 1990 to make health insurance a requirement for enrollment, two years after graduate students made the same move at campuses statewide. The Santa Cruz campus began its program last year.

If the plan is approved, each university would select a carrier that would provide local benefits to complement services that campus health clinics do not provide, officials say.

Many universities now offer basic health plans that do not require student participation. Under the new program, those plans would be made to cover additional types of health services and would be mandatory, university officials say.

Students who are able to prove that they have comparable coverage under a parent’s policy could waive the new insurance requirement. Low-income students would also be eligible for financial aid to cover the fees--estimated at $415 a year, officials say.

At Berkeley, about 24,000 students have enrolled in the university’s selected plan. “That’s 93% of our graduate students and 70% of our undergraduates,” said Covello. “The system works.”

Debbie Davis, head of the University of California Student Assn., says students deserve a say in the level of insurance required of them.

“We recognize the need,” said Davis, a graduate student at UC Irvine. “Mandatory health insurance keeps students in school.”

Mary Spletter, a representative of the UC system, said each university would adopt its own health plan and that student input would be crucial.

“Each campus has its own identity and serves students from different social and economic backgrounds,” she said. “But any plan would be deficient if student voices were not heard.”

Davis said the new insurance policy would come too late to help many of her friends, such as the UC Davis student without insurance who contracted leukemia and was forced to drop out of school to afford treatment.

“While successful in her battle against the disease, she still ended up with this huge financial burden that took up years of her life to pay off her debts and get back into school,” Davis said.

“For my friend, leaving school before her time, to take a full-time job to pay medical bills, was a demoralizing thing.”