Patient Protection and Affordable Care Act (ACA)

What this Means for Student Health Coverage in 2013

This past year marked a major change in health care for the United States. With the passage of the Affordable Care Act (ACA) back in 2010, this year has been filled with more clarity as the Supreme Court ruling upheld the constitutionality of the law and its future was sealed by US President Barack Obama’s reelection.

Looking back on this year, the Department of Human Health Services issued their final student health insurance regulations back in March. These regulations defined Student Health Insurance as a “written agreement between an institution of higher education and an issuer.” This meant that the Affordable Care Act would apply to student group insurance plans that contract directly with the insurance company (whether students are domestic or international).

What this means for your group plan is that:

  • Student health plans were granted a phase-in period for annual plan maximums ($100K for 2012-13, $500K for 2013-14); no annual maximums are allowed after 2014.
  • Waiting periods or limitations for pre-existing conditions cannot be imposed on students younger than 19 years of age (coverage for all begins in 2014).
  • Annual or lifetime limits cannot be applied to any essential benefits, including, hospitalizations, diagnostic tests, and maternity.
  • Wellness/preventative care must be covered without cost-sharing.

Later in June of this year, the United States Supreme Court upheld the constitutionality of most of the Affordable Care Act including the individual mandate. The mandate requires insurance coverage for individuals in the US however the impact on international students still remains unclear. While those in politics debated appealing the law, November’s reelection of President Barack Obama solidified that the Affordable Care Act was here to stay.

The impact thus far has been increased benefits with higher premiums. For some schools, the rate increase has driven some to look for other alternatives. Many schools are looking at exemptions to ACA like insurance plans that are considered “short term, limited duration.” Short term, limited duration basically means any plan under 12 months. Many carriers and schools are designing both group and individual plans that are 364 renewable to fall under this exemption until there is further clarification on the scope of the ACA in international education.

2013 is going to be an interesting year for international education in regards to health care reform We will continue to keep an eye on new industry changes such as how different insurance carriers implement these new requirements and what clarity we get as we near full implementation in January 2014. As this will most likely impact your plan over the next 12 months, we will be continue to post updates throughout 2013.

* Health Care Reform photo courtesy of Shutterstock

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