In the wake of President Trump’s election in 2016, my friends and I at the George Washington University (GW) were anxious about health insurance. We worried that Trump and a Republican legislature might overturn the entire Affordable Care Act. A loss of protections allowing young people to stay on their parents’ health insurance until age 26 would leave many uninsured and unable to afford insurance. It didn’t take long to realize that many of our peers shared these fears. Our concerns were only compounded by the shockingly high price of the student health insurance plan (SHIP) at GW, which would leave many of us with few options for affordable insurance.
As a 2017 Roosevelt Network summer fellow, I researched and advocated for changes to SHIP. At the time, SHIP premiums at GW cost an astounding $4,103 per year for domestic undergraduates. I worked with a team of students to secure affordable health care at GW and bring student voices into health-related decisions on campus.
When my team asked students about their experiences with health care at GW, we heard stories of health anxiety. Many uninsured students were afraid and unable to seek care unless their conditions were unbearable, often landing them in the emergency room and costing hundreds of dollars.
My team worked throughout 2017 to build coalitions and advocate for lower costs before university officials. We advocated for a mandatory hard waiver to SHIP, under which students would need to opt out of SHIP by proving that they had other insurance. This system is in place at most other colleges and, as we argued, would lower costs by shifting the insurance risk pool for the plan and guaranteeing that all students had insurance. We also pushed the university to provide more assistance to low-income students to help them afford insurance coverage. Finally, we advocated for the creation of a Student Health Advisory Council (SHAC) to bring students and administrators together to address campus health issues. We published these recommendations in the policy paper I wrote as part of my Roosevelt summer fellowship.
In April 2018, after over a year of advocacy, GW announced changes to SHIP and health services, which were in line with our recommendations. The changes reduced premiums by over $1,400 with no change in the quality of coverage. We also officially established SHAC and began meeting on a regular basis. Other changes made at this time included an electronic health records system and increased free mental health sessions.
The reduction in health insurance costs is remarkable. Many students expressed happiness that an affordable plan was there if they needed it. According to a recent article in the GW Hatchet, students are still content with this affordable option, with fewer students electing to waive the plan in 2019 compared to 2018 (8,800 students waived in 2019 compared to 9,600 in 2018). The article includes an interview with a sophomore who purchased SHIP after her parents divorced and she was left uninsured. Although this student intends to join one of her parents’ plans soon for in-network coverage with her health care providers at home, the affordable coverage allowed her to stay insured during a period of change in her family.
Just weeks ago, GW officials announced additional positive changes, including expanded clinic hours and a new clinic location. Students at GW have long complained about the university’s focus on profit over student health and wellness. In a promising quote for the GW Hatchet last month, Vice President for Student Affairs and Dean of Students Cissy Petty said, “What happens sometimes is that, if students don’t use a facility often enough, then we say, ‘Well, it’s inefficient,’ instead of that safety and care are more important than the efficiency . . . I’m going to work to put safety and care first, and I’m not going to worry about the revenue.”
GW administrators rarely speak openly about valuing student wellness over revenue. This shift in tone is notable, though GW administrators have historically issued empty promises to students fighting for change. Nevertheless, it is doubtful that health administrators at GW would have shifted their tone so drastically without pressure from students, both within and outside of SHAC. Many of these changes are thanks to the GW Student Association, which now runs SHAC. I am thankful for every member of the student association who has pushed for student-focused changes to health services at GW.
Although these changes have been beneficial, there is still room for improvement at GW and many other schools. Students at GW are currently pushing back against clauses in SHIP regarding self-harm and gender-affirming surgeries, which the plan does not cover. In hindsight, I wish my team had fought back against these clauses during our advocacy. I am hopeful that SHAC will be effective in helping students advocate and find solutions to remove these clauses from the plan.
I hope that my team’s successful advocacy will encourage students who are frustrated with health care on their campuses to take on similar projects. Health issues present a unique opportunity for students to build coalitions with campus officials to create a healthier environment for everyone. I hope that Medicare for All will soon be a reality, so that students won’t need to fight for change on a case-by-case basis. Until then, students deserve universities that prioritize their health through affordable student health insurance.