I support a simpler health care system. That is my number one priority. Thus I am unimpressed with the health care reform platform of our newly elected president. I do share the hope and optimism of many that meaningful change can and will happen.
But getting a simpler health care system means that some of the stakeholders need to be cut lose from the system. That is a politically daunting task. It is why most health care reform proposals try to add more patches to what is already a shabby patchwork quilt of private and public programs.
One effort does try to simplify a small part of our current system. At least 30 states have mandated that insured health care plans cover all children until they reach a certain age. Yet as simple as this concept is, it comes with more variations than states that have adopted it.
What are we trying to simplify?
Most health plans offer parents with dependent children in college the opportunity to continue coverage for their child if they provide evidence that the child is enrolled in a qualified post secondary education program.
This is a holdover from the days when children entered the job market after high school and those jobs provided health insurance. Today, it is more likely that neither half of that statement is true. It is an obvious adaption to changing times. It is a relatively easy way to expand coverage to a vulnerable population. Young adults are healthier than the general population and therefore not an expensive expansion. Of course, that doesn’t prevent this trend’s detractors from referring to it as the “slacker mandate”.
It also simplifies plan administration. Parents know the headaches of getting colleges to certify their child’s student status or certifying the insurance status to the college. Likewise colleges incur an additional administrative burden. In addition many colleges administer their own student health plans. That cost becomes part of the additional cost of college tuition. Only 30% of colleges require students to have health insurance.
For our plan it is one of the more persistent headaches. We regularly send notices to parents and students asking them to update their student status. Invariably, they forget until a need arises. And then it is a crises. And the crises usually occurs when the college is not in session and their administrative staff is on reduced hours.
But even an intention as straightforward as this ends up as a patch that covers a small percentage of its targeted audience. State insurance mandates only cover plans regulated in their states. They do not affect plans regulated by ERISA or government plans (including our plan). And 30 plus separate mandates in as many states certainly does not simply administration.
But the US congress didn’t make it simpler when they passed Michelle’s Law. Their idea of relief is to cut as small a patch as necessary that plugs a tiny hall in that quilt. Admittedly a hole that shouldn’t be there. It affects only those students with coverage who are forced to reduce their course load or leave college because of an illness. A uniform mandate to cover all dependents to a reasonable age would make a lot more sense.