Notre Dame grad students closely watch health care debate [South Bend Tribune, Ind.]

By Margaret Fosmoe, South Bend Tribune, Ind.

McClatchy-Tribune Information Services

April 23--SOUTH BEND -- National health care reform is a hot topic these days, but cost and availability of health insurance have been major issues for years among University of Notre Dame graduate students and their families.

Because of the cost, spouses and children of many Notre Dame graduate students are uninsured. And, ironically, if the federal health care law stands, it might result in much higher premiums for students and their families.

The cost of coverage for spouses and children is the major insurance concern voiced among graduate students, said Victoria Lam, a biology graduate student and chair of the Graduate Student Union's health care committee.

Nearly all Notre Dame doctoral students receive annual stipends, which will start at $18,000 for 2012-2013. For any graduate student who receives a full stipend (about 1,300 students), the university also subsidizes most of the cost of his or her annual health insurance premium.

For this academic year, the policy premium is $1,666 per student and the university pays 71 percent of that cost. For 2012-2013, when the premium will rise to $1,886 per student, Notre Dame will cover 75 percent. (As recently as 2008, the university subsidized only 29 percent of the premium.)

"I've had two major priorities in terms of funding -- the first is stipends and the second is health insurance," said Gregory Sterling, dean of the Graduate School since 2008. "We were behind. We've tried to make some significant progress in those areas."

Costs 'through the roof'

Although the university steadily has increased stipends and insurance subsidies, the cost of insurance is rising each year, so it's a never-ending catch-up game, according to Sterling. "The cost of insurance has just gone through the roof," he said.

Health coverage for graduate student families has been a concern for students and the university for many years, said Ann Kleva, director

of University Health Services. Each year or two, university

administrators review insurance plans, comparing premiums, deductibles

and benefits in order to choose the best and most affordable, she

said. She thinks the current Aetna plan is very good.

About 3,400 students are on the university's plan, but just 67 spouses

and 76 children.

Graduate students study and work on campus, but they aren't legally

considered employees. As part of their training, most graduate

students help teach courses, work in laboratories or assist faculty

with research.

Sterling said he is closely following the health care debate in

Washington, D.C., and will be awaiting the news in June when the

Supreme Court decides whether Congress went too far in mandating that

U.S. residents buy health insurance or pay a penalty.

The dean isn't sure whether he hopes that aspect of the law stands,

because the outcome is unknown.

"We've been told if it stands, we should expect our premiums to be

around $2,400 (per student) per year in 2014," he said. If an

individual who doesn't have the resources to pay for insurance will be

picked up for coverage, that would be OK, but if that person is simply

going to be penalized for not buying insurance, that won't help,

Sterling said.

Until details are ironed out by the federal government, the future

remains murky, the dean said. "In the meantime, we're doing all we can

to improve the situation," he said.

Costly insurance

Some graduate students have spouses who are employed, so family

members obtain insurance through the spouse. If the spouse doesn't

work, many students forego adding their spouse and children to Notre

Dame's insurance plan because of cost: $4,716 this year for a spouse;

$2,830 for one child; and $3,679 for more than one child.

The university doesn't subsidize any of the cost for a spouse or child

on the insurance plan. That's a fact that many married graduate

students want changed. They want Notre Dame to subsidize some of the

cost of health coverage for their families.

Married graduate students who can't afford family health premiums

usually enroll their children in Hoosier Healthwise, Indiana's

state-funded health care program for low-income families, pregnant

women and children.

Students appreciate the health insurance, but they want it to be as

inexpensive as possible, said Sam Rund, a biology graduate student and

president of the Graduate Student Union.

Rund, who is single, is on the university's plan. With the

university's subsidy, his portion of the annual premium is less than

$500 per year. "I knew there wasn't insurance out there that I could

get for under $500," he said.

Rund's academic specialty is the study of diseases of poverty. With

that in mind, he hopes the national health care law will stand and

that all Americans, including student spouses and children, will have

access to affordable health coverage. "I've been very blessed to be

insured my entire life," he said.

"I think grad students should pay something for the family care, but

something within their means," said Ricky Klee, a graduate student of

theology with a wife and two children. He said he can't afford the

premiums to place his family on Notre Dame's insurance.

Many graduate student families have to rely on charity clinics for

health care, he said. "Notre Dame is shunting off some of its health

care to the community. It's making it a state and a community burden,"

Klee said.

The cost of subsidizing graduate student family care would be

significantly less than other financial commitments Notre Dame has

made in recent years, such as athletic scholarships and executive

salaries, he said.

Klee doesn't think single students should have to pay more to

subsidize coverage for their peers' families. "I don't think that is

ideal. I think there are other ways the university can handle it," he

said.

Sharing the burden?

Students were asked in an informal survey by the Graduate Student

Union whether they would be willing to pay an extra $120 per year to

help cover the cost of subsidizing health insurance coverage for

graduate student spouses and children. The survey results were not

released.

Kirstin Hasler, a single political science graduate student, is

generally satisfied with the university plan. She's relied on it while

being treated for several minor ailments.

"I think overall it's pretty good. I wish it was a little bit

cheaper," she said.

She's frustrated at the notion of singles paying more to help provide

coverage for families. "It's a fairness issue," she said.

Hasler's boyfriend, Robert Brathwaite, also is a single political

science graduate student on the university plan.

He's satisfied with the coverage, but concerned about the rising cost.

And he's leery of the suggestion that single students should pay more

to help provide coverage for families of married students. Finances

are tight for all students, and even $120 more per year would be a big

sacrifice, he said.

"As graduate students, some of us made personal choices, and we now

need to accept responsibility for those choices," he said. Brathwaite

said he wonders why the financial dilemmas of some graduate students,

those with families, sometimes are considered more important than

issues facing single students.

Before singles are asked to pay more to help families, Notre Dame

needs to provide more information about the current finances of the

insurance program, he said. "There are a lot of questions that need to

be asked before you ask people to contribute," he said.

Health insurance plans for graduate students vary widely across the

United States, with additional variations between public and private

institutions.

Nearly 39,000 students attend Indiana University'sBloomington campus.

Some graduate students -- about 4,000 -- who are receiving stipends of

$9,000 to $18,000 per year to work as graduate assistants have a

health care plan paid for by the university, said Dan Rives, associate

vice president for human resources. IU doesn't pay any of the cost for

health insurance for graduate student spouses or children, he said.

Notre Dame graduate students have compared prices and policies at

various other research universities, and say some other schools offer

health insurance to student families at a lower cost than Notre Dame.

Sterling said it's difficult to compare student benefits because

levels of coverage, annual premiums and student stipends vary

enormously.

The health insurance picture is more complicated for international

students, because U.S. policies typically forbid foreign spouses from

working while in this country.

Peter Campbell is an international relations graduate student from

Canada with a wife and three children. Two of his children were born

in the U.S., so they are eligible for and enrolled in Hoosier

Healthwise. His wife, uninsured, doesn't go in for routine physicals.

Campbell is on Notre Dame's insurance, but said he can't afford the

premiums for his family. "We prefer to eat," he said wryly.

"I don't want to seem ungrateful. I'm exceptionally grateful for the

opportunities that Notre Dame has given me," Campbell said. But he

hopes to see the health coverage situation improved for student

families in the future.

Campbell said he realizes most single graduate students won't

volunteer to pay higher premiums to subsidize insurance for their

married peers' families. But he considers claims they simply can't

afford that to be rather cynical.

"If I can survive on my stipend with three kids, it's likely they

could survive with a slightly higher premium to help families and

those who are vulnerable," he said.

Relief coming

A new wellness center under construction on campus should provide some

relief after it opens July 1.

Although the center originally was intended just for faculty and

staff, the university now plans to also open it for use to graduate

students' spouses and children, who will have access at a reduced

rate. The center will provide a medical clinic and pharmacy.

Notre Dame's total graduate student insurance subsidy has grown from

$885,969 in 2008-2009 to an expected $1.98 million for next year.

Adding spouses and children of graduate students at a 75 percent

subsidy would double that cost to nearly $4 million for one year,

Sterling said.

To do that within the Graduate School's$100 million annual budget,

the dean said he'd need to eliminate about 109 doctoral student slots,

which would mean shutting down some academic programs.

That expenditure on a yearly basis would require a $50 million

endowment to produce enough income to subsidize insurance coverage for

graduate students and their families, he said.

Sterling said his goal is to eventually provide a 90 percent subsidy

for both graduate students and their families. The Rev. John I.

Jenkins, Notre Dame's president, and other top administrators are

supportive of that goal, but the issue is cost, he said.

"I'm all for it. I just don't know how to pay for it," Sterling said.

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Staff writer Margaret Fosmoe:

[email protected]

574-235-6329

___

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