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College Students and Grads Face Tough Health Care Challenges

Minority Dreams, News Feature , Francesca Gacho Posted: Nov 26, 2009

Amber Singam, 30, and her husband, Shankar, 34, are ready to start a family. They have waited for years, so when Singam graduated from Cal State Fullerton (CSUF) with her masters degree in May, everything seemed ready for a new addition to their family. All she needed was insurance coverage.

Back in August, Singam applied for private health insurance. She filed the paperwork, gave her medical history and any medical procedures she had undergone, but two months later she still hadnt received an answer. Singam called the insurance company and discovered that she had been denied coverage

A letter from the insurance company arrived the next day, stating she was denied based on her high risk for HPV, or human papillomavirus. For years, Singam had abnormal PAP smear tests, a routine gynecological exam of cells scraped from the cervix to detect cancerous or pre-cancerous conditions. She underwent a procedure four years ago to remove the abnormal cervical cells.

Since the procedure, Singam has received normal results from her PAP tests and has maintained a healthy lifestyle, so when she was denied insurance, it came as a surprise.

Singam among 21 percent of Americans who apply for health insurance and are denied coverage based on what is known in the insurance industry as pre-existing conditions, an issue that has come under fire in the recent health care reform President Barack Obama proposed.

As talks of improving health care focus on seniors and children, much of the debate has neglected the burgeoning population of college-aged students and recent graduates who may not be able to afford private insurance or seek jobs that offer health benefits in this recession.

The number of Americans insured through employers is 164 million, according to the Kaiser Family Foundation (KFF). However, with the economic recession and the new batches of graduates joining the work force every semester, looking for employers that offer health benefits are harder to find.

Though Singam was hired as a part-time instructor at a community college in September, her health benefits will not begin until next fall. She faces eleven months without health insurance coverage, but said she is willing to pay for private insurance, especially with their plans to have a baby.

I can afford to pay for private insurance, but I cant afford to give birth without insurance, Singam said. I am also not able to afford pre-natal care prior.

Resources and services narrow when students graduate and lose the student status many insurance companies require. But currently enrolled students traverse an equally overwhelming path. They often rely on student clinics or government and public health programs.

College students who have medical conditions that require treatment, like Patrick Cruz, a 23-year-old living in Alameda, may not have the money for private health care.

Diagnosed with psoriasis - a non-contagious autoimmune disease that appears on the skin as raised patches or lesions - Cruz has been fighting for insurance to get treatment.

He was a working student, employed at a local Starbucks, and attending Alameda Community College when he was diagnosed last October. At that time, Cruz was insured by his employer and was able to get some treatment. But he lost coverage when he wasnt able to meet the quarterly 240-work hour requirement to continue receiving health benefits.

I was missing a lot of hours because there would be day when I didnt feel well, Cruz said. I had to quit because [the lesions] were all over my face, too.

In December, he applied for Medi-Cal, but would not be seen by a specialist until February. By that time, his condition worsened and his plans of applying to the Respiratory Therapy program in a nearby college were put on hold.

Unemployed and short on money, Cruz and his family decided to go to the Philippines where his medicine and treatment would be cheaper. He returned to Alameda three months later with his skin partially cleared.

But flying back and forth to the Philippines isnt much of an option.

I cant keep getting a quick fix. I need something thatll last longer, he said. My condition gets so dependent on medications.

Though he has received treatment on and off in the past year, his condition hasnt improved. Regardless, he remains positive and hopeful that Medi-Cal will help him get the treatment he needs when he finally sees a dermatologist at the end of this month.

Until he gets private insurance, he relies on Medi-Cal and other low-cost options.

Knowing whats out there

Many alumni associations offer discounted health insurance for association members and some grads may qualify for public programs for low-income individuals and families.

Most colleges and universities also include health fees in registration and tuition fees for enrolled students. This gives students access to the on-campus health clinics which usually offer basic medical tests and procedures for free or for a small fee.

Roughly 55,000 student appointments are scheduled per year at CSUF, said Mary Becerra, the director of health education and promotion at the Student Health and Counseling Center on campus. The health clinic is a full-functioning medical clinic, able to perform many basic lab tests and examinations, provide affordable medications through its own pharmacy, offer reproductive health services, and family planning services.

CSUF has an enrollment of 37,000 students and the schools clinic is the most highly utilized student clinic in the entire CSU system, according to Becerra. Most students come during the high-stress times in their semesters - midterms and final examinations. With the flu season, the student clinic has also seen many upper respiratory issues.

About 70 percent of the students the clinic surveyed said they have some type of insurance, while the remaining 30 percent are the ones that are seen regularly - students who have limited or no access to any type of health care, Becerra said.

Though the student clinic offers a wide range of services, it is still limited. It is not equipped to handle medical emergencies and other serious conditions.

It is the emergencies - a broken arm or a chronic condition - that put students in financial troubles. This is where insurance becomes indispensable - for the what-ifs.

Becerra also noted that the University of California requires all students to have insurance coverage - either from a private provider or through the university. But based on tightening budgets of the CSU system and the recent tuition fee increase, it may be tougher to require insurance coverage for all students.

Mandatory insurance may be out of the question, she said.

Health care reform in the works

On February 4, President Obama spoke at the joint session of Congress and emphasized the need for a comprehensive health care reform. This speech marked the beginning of the heated debate about the condition of the nations health care system. Touted to be the biggest health care reform in decades, the reform aims to extend coverage to more Americans and control the sky-rocketing costs of health care.

About 46 million non-elderly Americans are uninsured, the KFF reports. This could be because of many reasons including unemployment, not meeting employers qualifications for insurance coverage or denied health insurance. Some college-aged students fall under these categories who, either willingly or not, forgo insurance coverage.

Recently, the House of Representatives passed an expansive health care bill that would guarantee medical coverage to 96 percent of Americans. The bill would place a tax surcharge on wealthier Americans as well as new taxes on individual and family plans whose values exceed the set amount, according to CNN. The plan would cost under $1 trillion in ten years.

Last week, the Senate Finance Committee introduced a health care reform bill that will cover 30 million Americans and would cost $849 billion over the next ten years. It is aimed to cut costs to individuals, companies and the government and increase efficiency.

Both bills include a public option plan, but with varying provisions and conditions. The House bill requires individuals to buy insurance, with steep penalties for not complying, which could reach up to 2.5 percent of the individuals income. The Senate bill is a bit more forgiving with fines that could reach up to $750 for not having coverage.

Though both houses have different bills in the works, both agree on broad changes including cutting down costs and preventing insurance companies from denying coverage based on past medical histories.

The Senate bill moves to the floor after Thanksgiving recess for a full debate by lawmakers, giving them an opportunity to introduce amendments to the bill. A long process awaits and a final version of the two bills would have to be approved before the president can sign it into law.

Working with what they have

Currently, CSUF offers insurance coverage for purchase through Anthem Blue Cross. The student insurance offers low-cost group insurance coverage to uninsured students and their dependents on either an annual or semester basis.

Nathan Fletcher, 32 and his daughter have been insured through CSUFs student insurance for two semesters now. Previously employed by a furniture store in Lake Forest, Fletcher was let go in February because of the recession and was concurrently attending college to fill pre-requisites for the credential program.

Nathan FletcherWhen he lost his job, he immediately signed up for health insurance through the university. It cost him $2,000 for health coverage. The fees include $1,100 to cover his daughter and another $1,000 for himself under the Domestic Student insurance plan.

Though he receives financial aid and works part-time as an Instructional Aide, Fletcher admitted that paying the fees at the beginning of every semester is stressful.

I have no choice. If I have to be prepared [for next semester's payment], I will be, he said. Its expensive to purchase, but the alternative is unfeasible.

Despite the price, it is still cheaper than private insurance premiums and the schools insurance gives him sufficient coverage for the price hes paying, Fletcher said.

Fletcher is one of the lucky ones able to navigate the options available to him and could afford coverage. Also, since the insurance on campus is a group insurance, whoever enrolls will get covered regardless of past medical history.

But depending on the students age, status and dependents, premiums range from $500 to over $2,000. All the fees are payable on the day the student signs up for insurance.

Students who dont have the money risk having no coverage and sometimes utilize the student clinic. Others see the fees and say no altogether, despite the ample coverage and low deductibles of student insurance. Some students just dont know where to begin.

Most students who have no access to insurance would have to figure it out for themselves, said Joe Vargas, whose Populations in Multicultural Health class at CSUF studies the disparities in access to health care for different groups.

Many undergraduate students are covered through their parents and guardians health insurance but some, who are no longer eligible because of insurance requirements, are left with a difficult decision.

Students today would have to learn how to maneuver the system, Vargas said.

He noted that students with families, such as expecting mothers, face an even harder challenge.

It must be challenging to balance pre-natal care, school, jobs and many other things, he said.

The battle of costs and available resources forces many college students to gamble with their health. Many of them would have to rely on faith. Faith that their immune systems dont fail and faith that nothing happens to them until they get a job with health benefits, or until the promise of a comprehensive health care reform becomes a reality.


Francesca Gacho holds a B.A. in English from Cal State Fullerton. She is an intern at Minority Dreams Magazine, where she hopes to spread her journalistic wings, explore and hone her writing ability, and gain insight into the myriad of issues in todays soundbite-focused world. Her writing interests include human interest pieces that delve into culture, arts, current events, and community service.




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