Final Federal Regulations on Student Health Insurance Plans Announced

03/16/12. The Department of Health and Human Services has announced the release of the final federal regulations [pdf] implementing provisions of the Affordable Care Act (ACA) as they relate to the continued operation of college student health insurance plans. We are pleased that these regulations are finalized since many institutions of higher education are negotiating their student health insurance plans for the 2012-2013 academic year, and are assessing future impacts. Their release removes some of the previous uncertainties.

These regulations have been issued subsequent to draft regulations (Notice of Proposed Rulemaking CMS-9981-P) [pdf] that were released by the Centers for Medicare & Medicaid Services (CMS) on February 11, 2011. ACHA had previously submitted its comments to the proposed rules [pdf] on April 12, 2011 advocating for: 1) clarification that premiums for student health insurance plans may continue to be determined based on their unique college population; 2) a mechanism for self-funded plans to be designated as “minimum essential health coverage” thereby satisfying the individual mandate; and, 3) flexibility regarding the choice of primary care provider. Additionally, our comments advocated for eligible students enrolled in student health insurance plans to be afforded access to the premium subsidy.

Importantly, we note that many college students on campuses throughout the nation have come to rely on their locally available student health plans as vital access vehicles to meet their requirements for primary care, prevention services and referrals to other care. As institutions determine their strategy for providing care and advise students about viable health insurance options, ACHA recommends that you continue to work closely with your insurance vendor(s) regarding the potential impact of the ACA on your student health insurance plans. We encourage you to include health care plan advisor(s) and campus legal counsel in discussions related to these projected impacts and your plans to address them.

We urge you to provide notice of your decisions regarding student insurance coverage options for the 2012-2013 school year to currently covered individuals as soon as possible. This is especially critical if your institution decides to no longer provide the coverage that students have relied on in the past. We suggest that notification be delivered in multiple formats, repeated several times prior to the end of the current coverage period, and include suggestions for alternative coverage (e.g. individual plans in the region/state, parental coverage through age 26, Medicaid, state insurance risk pools, and the Pre-existing Condition Insurance Plan if applicable.)

ACHA will be examining these finalized regulations in further detail to determine their potential effect on student health insurance coverage going forward. Additionally, we will continue to monitor developments on other issues related to ACA implementation that affect students’ option for choice including: any further changes to rules on Establishment of Exchanges and Qualified Health Plans (CMS-9989-F) or the elements of the Essential Health Benefits coverage package; and, opportunities to facilitate increased use of Medicaid funds to purchase student health insurance coverage for low-income students. ACHA also remains keenly focused on the challenge of health insurance coverage for international students.