Tuesday, January 17, 2017
A Phrase I Never Want to Hear Again
“I need this class to stay on my parents’ health insurance.”
I used to hear that a lot, back in the pre-ACA days. And it was true. Back then, students needed to be enrolled in at least twelve credits to be eligible to stay on their parents’ health insurance. I used to work in-person registration back then -- before things went entirely online -- and I recall some brutally frank conversations with students about insurance. They were working low-wage jobs that didn’t provide insurance, and they couldn’t come close to affording health insurance on the individual market. But they could afford an extra class or two, especially at community college tuition levels and with financial aid.
College became a workaround.
Back then, lifetime Pell eligibility was 18 semesters, and health insurance was the Wild West.
Students taking classes just for insurance purposes wreaked havoc with course completion rates, pass rates, and graduation rates, among other things. I used to get students begging not to get dropped from classes they may only have attended once, arguing on humanitarian grounds that they needed the coverage. It wasn’t quite “if you flunk me I’ll get drafted,” but it was certainly an unwelcome intrusion into what should have been academic decisions.
Over the last six years, the situation changed in two major ways. The first was the passage of the Affordable Care Act, and the second was the reduction in the lifetime Pell limit from 18 semesters to 12. Suddenly, “college as a workaround” didn’t make sense anymore. Now health insurance is much easier to get, and financial aid is more limited. Colleges have been either freed or forced (whichever you prefer) to focus more on getting students through and on their way.
While I have my objections to the reduced Pell limit, especially in the context of students who need ESL instruction, I’ll admit that the combined effect has been to pressure colleges to look more closely at some crucial issues, often to the good.
I bring this up because there’s much talk of the new administration repealing the ACA, but no talk (as far as I know) about it restoring the old Pell limit. From a student standpoint -- and from an institutional standpoint -- that would be the worst of both worlds. Either we’d see a return of “I need this class to stay on my parents’ health insurance,” only this time in a setting with “performance funding” and tighter aid rules, or an effective abandonment of insurance altogether.
The former would be both a humanitarian problem and a practical one. Colleges’ funding would be predicated on their success with students who never actually intended to succeed, and students would be forced to use scarce aid when it wouldn’t make academic sense. The latter would be an unconscionable disaster, a form of intergenerational war.
Of course, this all assumes the absence of a better alternative in the ACA’s place. If that assumption turns out to be wrong -- if TrumpCare provides inexpensive, ubiquitous, excellent coverage to all who need it -- then I happily withdraw my objection. If people are able to get coverage no matter their enrollment status, and are able to make academic decisions entirely on academic and career grounds, we’ll all be better off. I would be elated to write an apologetic retraction in the face of a saner and more sustainable system.
But I’ve been in this line of work long enough to remember when academic decisions were made on the basis of health insurance. Those conversations were awful, and the ethical dilemmas no-win. We know that. I know that. That system emerged as an accident of history; it was a mistake born of wartime wage controls and Cold War red-baiting. We made that mistake once, and learned from it, at terrible human cost. Making that mistake a second time, when we know what it means, would be unforgivable.