BYU student health plan could teach students a lesson in ACA penalties

Students at Brigham Young University (BYU) can no longer rely on their university health plan to meet the requirements of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). Due in part to BYU’s refusal to offer a student health plan that includes birth control coverage, the university’s student health coverage does not qualify as “minimum essential coverage” under the ACA. As a result, students who intend to retain health care coverage through the university could face fines for not having a qualifying health plan.

Requirements

The ACA requires that student health plans—like other plans—meet certain minimum requirements. Among those requirements, according to the Kaiser Family Foundation, is the obligation to provide “without cost sharing, access to all FDA-approved contraceptive methods, sterilization procedures, patient education and counseling prescribed by a health care provider.” The ACA also requires that plans not put caps on coverage and the BYU plan has a $250,000 ceiling. As pointed out by an editorial article in the Salt Lake Tribune, while there are specific requirements on the nature of the plans offered by the university—if its elects to offer one and expects its plans to meet ACA standards—there is no mandate that BYU offer its students any plan at all.

The Plan

In BYU’s recent statement regarding the 2015 BYU Student Health Plan, the university explained that, as of August 31, 2015, the university would not provide health insurance that met the “minimum essential coverage” requirements. Despite the fact that the plan is no longer compliant with the ACA, the university told students that the plan would continue to be compliant with BYU’s health coverage standards and remained “an excellent alternative for many students.”

Students’ alternatives

Of course, students are not stuck with selecting the BYU plan and paying a penalty under the ACA. If students are under 26 years of age, they can stay on their parents’ coverage until they hit 26. Students can also purchase coverage through the ACA on healthcare.gov. In fact, many of the options available there rival the cost of the BYU plan.

The school’s alternatives

The school, as already noted, could have elected to provide no plan at all. In fact, that was the tactic adopted by Wheaton College, a Christian liberal arts university in Illinois. As a result of the college’s moral objections to the ACA’s contraceptive mandate, the school announced on July 10, 2015, that it would drop its student health plan because the alternative “would force the College to provide morally objectionable products and services.” Wheaton College dropped the plan after the Seventh Circuit’s July 1, 2015 decision denying the college’s request for a preliminary injunction to bar HHS from enforcing the ACA’s contraceptive mandate against the college. School officials at Wheaton College indicated that they would not request a religious exemption to the contraceptive requirement because the school’s insurance company would still be obligated to provide the coverage.

Plan update

If, unlike the case with Wheaton College, contraceptive coverage was not the determinative factor in dropping coverage, BYU could have updated its plan.  If a total abandonment of student health coverage wasn’t necessary, BYU could have taken its lead from the University of Utah, which reportedly made changes to its plan—lifting annual and lifetime limits and adding provisions for prescription reimbursement—in order to make it compliant with the ACA. Instead of choosing either of those alternatives, BYU struck a middle ground, which could put some students in an awkward position of paying a fine because their school’s plan doesn’t satisfy the law.

Impact

According to coverage from KSL Broadcasting in Utah, about one-third of the student body at BYU was enrolled in student coverage when the announcement was made. According to KSL, BYU spokeswoman Carri Jenkins indicated that school officials believed that most of the students affected would either “qualify for or fee exemptions based on their income or will able to get onto their parents’ health insurance.” As a counterpoint, KSL also reported that Dodd Greer, an ACA navigator at Community Health Connect in Provo, Utah, has already received multiple calls from BYU students who are concerned about avoiding fines that could result from the BYU plan’s noncompliance with the ACA.