You have probably wondered what would happen if you were to contract COVID-19 tomorrow. What kind of care would you require, and would you receive it? And—a question causing as much stress as the illness itself for many—would you be able to pay for it? Unfortunately, if you’re a student who is relying on Columbia for health care this semester, you may be right to worry.
The University is offering free COVID-19 testing for faculty, staff, and students, but it has yet to make substantive commitments to cover the medical bills that are common with serious cases of COVID-19. Under the existing Aetna plan—which Columbia students are required to enroll in unless they can provide evidence of comparable insurance—hospitalizations are subject to a 10 percent coinsurance (meaning that 10 percent of the cost falls upon the student). Aetna has waived coinsurance for COVID-19-related inpatient care, but this does not cover some of the most burdensome costs of hospitalization, such as ambulance transportation. Considering that surprise fees have sent many COVID-19 patients’ bills into the tens of thousands, patients’ bills could very well approach the plan’s out-of-pocket maximum, even with the COVID-19 waiver. This means that, should a student on the Aetna plan contract the virus and face complications that require hospitalization, they could be footing a substantial bill of up to $3,000. This bill could grow even larger if they end up in an out-of-network hospital, encounter copays, or require follow-up treatments.
This coinsurance hasn’t always been written into the only plans available to students. The 100 Plan, an option nearly free of in-network coinsurance, was available until August 2019, when Columbia implemented the latest round of cuts to student health care by collapsing the two health insurance tiers into a single option. This prevented students who foresaw having extensive medical needs from opting into a better plan, which would save them money in the long run. While communications about the plan painted a compromise between the original options in terms of premiums and a win-win in terms of out-of-pocket maximums, the University failed to underscore that 10 percent coinsurance was now written into the only student option. It also failed to make clear that the coinsurance provision exacerbates financial vulnerability for students previously enrolled in the 100 Plan who already have high medical costs.
Columbia was more transparent about this effect during bargaining with the Graduate Workers of Columbia-United Auto Workers, the union for teaching and research assistants. Since this insurance plan restructuring stripped many graduate workers of their access to more affordable and comprehensive health insurance, the University stood to gain almost $500,000 every year by the GWC-UAW’s estimate. When confronted with this fact, lawyers explained that the new plan simply followed nationwide trends of shifting costs from the institution to the user.
This cost-cutting tactic of shifting costs onto the patient is in fact a nationwide trend, one that has come under long-overdue attacks since the start of the pandemic. GWC-UAW has been on the front line fighting to reverse the effects of the 100 Plan’s elimination, but the current public health crisis makes it more clear than ever that all students have a stake in contesting rollbacks of our insurance.
GWC-UAW is now proposing numerous improvements to health care across Columbia, including cheaper coverage for prescription drugs; emergency, mental health, and gender-affirming health care services; and vision and dental care. These demands are especially necessary for student-workers with chronic health conditions who are facing skyrocketing costs for vital health care services due to the 10 percent coinsurance policy and the lack of coverage for certain kinds of services.
These costs pose a significant challenge for graduate student-workers at Columbia, considering the high costs of rent in Manhattan and the relatively low stipends that graduate workers receive. The $3,000 out-of-pocket maximum for the in-network student health insurance plan ($6,000 for out-of-network) represents more than 10 percent of a doctoral student’s annual income. For families, the challenge is even direr, with an out-of-pocket maximum of $12,700 for in-network services, and no limit for those out of network. This penalizes students with spouses and/or dependents, quadruples out-of-pocket costs even for students only adding coverage of one dependent, and could bankrupt families if they go to an out-of-network hospital. With a significant share of that income already going to rent, this poses an impossible burden for student-workers.
Since the start of the pandemic, student groups like the Columbia People’s Coronavirus Response have also put forward additional urgent demands relating to health care. The group has many demands for Columbia Facilities and Operations, which oversees Columbia Health. First, the group states that Facilities must reimburse all out of pocket health care costs linked to the treatment of COVID-19. Second, it must provide graduating students the option of extending their student health insurance coverage. Third, CPCR demands that Facilities ensure that no worker will lose health care coverage due to changes in employment, hours, status, or classification for the duration of the pandemic. The group also asks that Facilities ensure that no employee or student insurance plans will be changed unilaterally to the disadvantage of insured students and workers, and that all students who take a leave of absence will retain their right to Columbia student health insurance.
So far, Columbia has conceded to none of these demands, despite the fact that over 1,000 Columbia affiliates have signed in support. Given that the pandemic shows no signs of letting up, these demands are just as urgent now as they were in May. Students should not need to jump through hoops; comprehensive coverage should be accessible for all of us. The struggle to restore and improve affordable health care for student workers should mobilize us all to challenge unilateral, cost-cutting decisions made by the University.
The coronavirus pandemic has emphasized that adequate and affordable health care is a prerequisite to the health and safety of all. Until we win universal health care for all, unions must continue to be at the forefront of the struggle for improved coverage and benefits. Health care is a human right, and the University should start treating it as one.
Becca Roskill (SEAS ʼ22) and Emmaline Bennett (TC ʼ22) are organizers with the Columbia-Barnard Young Democratic Socialists of America. Their column, A Spectre Haunts Columbia, runs alternate Tuesdays. They encourage you to show solidarity with a pressing student-worker demand by signing the CPW-UAW Petition to Extend the Emergency Childcare Benefit.
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