Even by the admission of its drafters, the new health insurance reform law is complex, but two members of UNM’s health and medical community are here to explain it.
Beverly Kloeppel, director of UNM’s Student Health and Counseling, and Nancy Ridenour, dean of the College of Nursing, agree that the new Patient Protection and Affordable Care Act will have a significant impact on young adults.
The most immediate impact will be on young adults, who now have the ability to stay on their parents’ health insurance until the age of 26, Kloeppel said.
People aged 19-29 make up one-third of the uninsured population in the United States, Kloeppel said. Starting in September young people will be able to remain on their parents’ health plan, creating a larger pool of people accessing the health care system, she said.
This has implications for student health centers like the SHAC because they may see more demand from the newly insured population.
As Ridenour said, the law dramatically increases funding for providers in “primary care services” — or services such as care of minor illnesses, management of stable chronic diseases and disease prevention.
The SHAC, for the most part, specializes in primary care services.
Ridenour said one mechanism for broadening access to primary care services was to require, as the new law does, that health insurance companies cover certain preventative primary care services.
“Prevention benefits won’t be charged for. They’re part of your insurance package,” Ridenour said. “That’s a big step forward because many times prevention things are an extra charge and so people don’t routinely get them.”
Ridenour said it’s critical that young adults routinely receive preventative health care services for the sake of their health and finances.
“If we can help with prevention and early intervention then we can improve their health overall and then certainly decrease costs because they don’t need the more specialist intervention,” she said.
Still, it is unclear whether a group of newly insured students will access primary care services offered at places like the SHAC; nor is it clear the extent to which insurers will cover services not considered primary care
services, Kloeppel said.
As Ridenour said, the rules and regulations for the law have yet to be fleshed out. This means it is still unknown what sort of health insurance regime would be available to specific “pools” of people, like the student pool.
What is known, Kloeppel said, is that in addition to the mandate to purchase health insurance by 2014, states must also have established what are called “health insurance exchanges” by that same year.
Essentially, Kloeppel said these are markets where customers can shop for a health plan offered by insurers who have to meet certain standards or offer certain services to even enter the exchange.
Kloeppel said it is unknown if there will be student-only exchanges or exchanges only for young people because the regulations still have not been written.
If exchanges were created exclusively for young people or students, then both groups would see low-cost health insurance, Kloeppel said.
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“Students tend to be a fairly low-risk population to insure. And it depends on how they distribute that risk. Are they going to have students in one pool, and say, all of those students in the state are going to risk stratified together?,” Kloeppel said. “That would result in lower cost insurance to students.”
Conversely, if by 2014 students and young people are required to purchase through exchanges that include high-risk populations, then health insurance could be high, Kloeppel said.
Asked if a population of newly insured young adults will be a strain on the health care system, Ridenour said, “Initially, probably. But overall it’s going to be really fantastic to get people early on.”
Ridenour said encouraging people to adopt healthier lifestyles is key to a cost-effective health care system.
“The point is, if indeed we can help people in our country live healthier lives, then the way we provide health care is not so costly,”
she said.
Ridenour also said that for students considering a career in health and medicine, now is a good time to consider entering the field. To meet the anticipated nationwide demand for primary care services, the law creates funding to train people in every imaginable health care field, Ridenour said.
UNM will receive funding for work force development in health care fields, she said, and the Health Sciences Center has task-force groups looking at how the funding will impact UNM.
