In the United States today, one out of every six Americans goes without health insurance. But none of them is a student here. Like most private four-year colleges, Wesleyan mandates that every student have health coverage while enrolled. The majority of students are insured through their parents’ plans, and the rest—around 700 Wesleyan students this year—are covered under a University-sponsored plan.
But what happens when seniors graduate? Unfortunately, there is no mandate for health insurance in life beyond campus. When students leave college, they are most often dropped by their parents’ insurance companies. So on Commencement Day, Wesleyan students join the legions of Americans angling to get health coverage—or at least hoping not to get sick.
There is a time-honored solution to this problem: get a job. American healthcare is organized around Employer-Sponsored Insurance, which means that people are expected to get health insurance through the organization that gives them a paycheck. Now there’s a recipe for compounding social inequalities. To have the best chance at good health, you have to be able to find a job—often in fulltime work with a large organization. In the United States, 60 percent of people get their health insurance through their employer.
But in this economy, it is hard to find any job, much less the kind of job that offers health insurance. In October, The Argus reported the results of the Career Resources Center’s “First Destinations Survey,” which found that more than a quarter of the class of 2009 was still looking for work three months after graduation. Fortunately, 42 percent of the class had found some form of work, but this was down 10 percent from the previous year.
That does not account for the 13 percent of the Class of 2009 that was “undecided” about what to do next. Maybe they want to be artists, activists, parents, entrepreneurs, travelers, or farmers. If so, they will have to pay for private insurance out of pocket—to the tune of several thousands of dollars each year (depending on the plan). Perversely, if Wesleyan grads dip down to poverty line, the government safety net, Medicaid, may kick in (but there is no guarantee). The other alternative is to go without insurance altogether, but let’s not speak of that. Health insurance is expensive, but it is not optional.
Right now, there are two bills in Congress that could make Wesleyan a microcosm for America. The healthcare overhaul would mandate that all Americans carry insurance—or else pay a hefty tax, which would be phased in gradually over the next decade. The idea is to make it more sensible for people to have insurance than to go without. Paternalistic? Yes. Appropriate? Absolutely.
Given that all Americans would be on the hook to buy health insurance, one big aim of the overhaul is to make insurance more affordable. The bills propose to do this, first, by letting more into the public programs that already exist, such as Medicaid (for low-income people) and Medicare (for older Americans). Second, more people would be able to enroll in Employer-Sponsored Insurance plans because the government would tightly regulate private insurance companies. Finally, the government would set up insurance “exchanges,” through which anyone could buy a policy if they found themselves in the (shockingly common) situation of not having affordable insurance available through an employer.
Heading into winter break, the most important thing that seniors should do is take the time to figure out when their coverage will end (or how long they can extend it and at what price). Second, all students can take the time away from campus to chat with older relatives and neighbors about healthcare reform. Polls consistently show that older Americans are the most resistant to healthcare reform because they want to protect their Medicare benefits. Finally, students can tune in to the debate. The details can feel overwhelming, but Peter Orszag, who is President Obama’s Budget Director, keeps a pretty readable and canny blog on healthcare reform.
If healthcare reform does pass, then we can have even more to celebrate next holiday season—and less to worry about on graduation day.