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Davis, California

Tuesday, August 3, 2021

Affordable Care Act expands to cover women’s health services

UC Davis students could receive free preventative care services ranging from diet counseling to vaccines to lab testing at the on-campus Student Health and Wellness Center (SHWC). But they are paying.

Since Sept. 23, 2010, the Affordable Care Act (ACA) has mandated that all health insurance plans cover clinical preventative services without patient co-pay. Effective August 2012, the ACA is expanding mandated coverage to include women’s preventative health services, such as well-woman visits (such as pelvic and physical exams, health tests and immunizations) and contraception.

UC Davis students cannot use their health insurance on campus at SHWC, so they cannot benefit from the free services the ACA provides.

Nationwide, universities are making the switch to the new model of on-campus health care that acts as a fully functioning clinic, providing students a wider range of care and allowing them to bill their insurance and benefit from the free preventative care services that the ACA requires. Bowling Green University, Southern Georgia University and University of Massachusetts are only a few of many universities that have switched to the in-network model.

Dr. Glenn Egelman, former health services director at Bowling Green State University in Ohio calls it a crisis.

“Students at UC Davis are struggling to pay for rising tuition,” Dr. Egelman said. “On top of that, they pay for health insurance that they can’t use at the new, multi-million dollar health center?”

Virginia Bryant, a SHWC insurance services employee, said her department doesn’t have access to the number of students that already pay for health insurance before coming to UC Davis.

Bryant said the great thing about the center is the availability of their services to all registered UC Davis students regardless of their health insurance coverage.

“Most people we see have the UC Student Health Insurance Plan (SHIP) and that’s about 13,000 to 14,000 students,” Bryant said.

All UC Davis students are required to have an insurance plan in order to enroll in classes. That means, the majority of UC Davis students have opted out of SHIP and are insured under a private plan.

Students pay the same price for general visits, specialist visits and some lab-tests whether or not they have SHIP. This is a low fee that is subsidized by the university.

Dr. Egelman said that the current system at SHWC is resulting in revenue losses and unnecessary student costs.

“If students could bill their insurance, the SHWC would not have to subsidize payments,” he said. “Insurance would pay about five times the amounts of subsidized student payments.”

Dr. Egelman said the University of California still bases its health care off the old model of on-campus health care, but is working to aid them in the transition.

“The old model was to help students with small issues and get them to the nearest hospital quickly,” he said. “But with the inception of a new multi-million dollar facility, that model is obviously changing so that it can serve more students more thoroughly.”

Emily Mekinna, a junior international relations major wonders why UC Davis hasn’t made the switch yet.

“We just build this brand new health center where we can do all sorts of things that the old clinic couldn’t do,” she said. “Our facility was upgraded, shouldn’t we upgrade our system?”

Transitioning to becoming an in-network facility is a laborious process, according to Bryant. SHWC would have to credential of its all health care providers and implement a new system of submitting bills and collecting payments.

The university can take two paths to becoming in-network: hire more employees to facilitate the transition or outsource the job to a company, such as Vivature Health LLC.

Dr. Egelman, who is also the chief medical officer at Vivature said that they service universities around the nation.

“Becoming in-network is immediately cost-effective,” he said. “Every university we have worked for has thanked us, students, health providers and administration alike.”

SARA ISLAS can be reached at city@theaggie.org.

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