New healthcare law has got you covered

By Sam Hayes

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The United States Supreme Court ruled in a 5-4 decision over the summer to uphold the majority of the 2010 Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare.

The decision, despite earlier efforts to repeal and overturn the law, means the Affordable Care Act will be in full effect as of 2014. All U.S. citizens will have new healthcare laws.

But how will Obamacare affect a University of Massachusetts student?

The first thing that the PPACA does is add another layer to the healthcare bureaucracy that a UMass student faces, which includes Massachusetts healthcare laws as well as UMass insurance requirements.

Some aspects of the PPACA will not be anything new to UMass students, such as the individual mandate that requires all U.S. citizens to get health insurance under threat of tax penalty. A version of this rule, and other rules in the PPACA, has already been in place in Massachusetts at the state level since former Gov. Mitt Romney’s passage of the Massachusetts Health Care Insurance Reform Law in 2006, commonly referred to as Romneycare. But other aspects of the PPACA will be new, such as how long young adults can remain under their parents’ insurance.

It is still yet to be seen what the full impact of the PPACA will be for UMass students. University Health Services Director Alan Calhoun said UHS will continue to adjust to the PPACA as the ways of implementation are developed.

“We don’t have specifics at this time. The regulations for the ACA are still being constructed and released,” Calhoun said.

Here are some of the specific ways that the Affordable Care Act will affect the average UMass student as of now:

If you are under 26 and either of your parents have healthcare, so do you. Effective Sept. 23, students can continue to be on their parents’ insurance until they are 26, a change from former rules where students would lose parental insurance after graduation.

If you graduate and can’t find work, you will still get healthcare. Effective in 2014, if you are unemployed and make less than $15,000 per year, you will be covered by Medicaid.

You will get a refund check if your insurance company does not spend your money on you. The PPACA has a new “80/20” rule that applies to all insurers, including college insurance. The rule means that at least 80 percent of all premiums paid to an insurer must be spent on medical healthcare and not on salaries and advertising. If the insurer does not comply, they must pay the difference back to customers in a rebate check. In 2012, 12.8 million Americans will receive $1.1 billion in rebates, or roughly $151 per household, according to, the government’s site for PPACA information

You will get health insurance because you have to. Students and individuals all across the U.S. will be required to obtain health insurance or pay a tax penalty starting in 2014 under the individual mandate. A similar program is already in effect in Massachusetts, where 98 percent of all residents have health insurance, the Boston Globe reported in June.
If you are out-of-state, or choose to pay a tax penalty, you are still required to have health insurance through the University. UMass requires all students to have health insurance and automatically signs up and charges every student, taking more than five credits for the University-sponsored health plan for a total of $2,755. Students having pre-existing insurance that is compatible with UMass’ requirements can waive this insurance online through SPIRE before Sept. 17.

If your employer doesn’t offer health insurance, someone else will. Under the PPACA, there will be state or federally-run insurance markets as part of the Affordable Insurance Exchange. The exchange is planned to be a competitive market where individuals and small businesses can buy insurance at affordable prices. Although the exchanges are scheduled to start in 2014, Massachusetts students and residents already have one called the Commonwealth Health Insurance Connector Authority, or Health Connector, from the 2006 law.

If your employer doesn’t offer insurance and you are earning below a set value, the U.S. government will help. As of 2014, an individual making less than $43,000 may get a federal or state tax credit to pay for insurance.

If you are under 19-years-old, you will be covered. Job-based or individually purchased healthcare will no longer be able to exclude or deny coverage of any person under the age of 19 beginning in 2014.

You will no longer need a co-pay to be tested, screened or vaccinated for a variety of procedures. Preventative services, such as screening or testing, must be covered without having to pay a co-payment, co-insurance fee or deductible. Birth control, H.I.V. testing, S.T.I. counseling, alcohol screening, tobacco-use screening, diet counseling, depression screening, PAP tests, mammograms, new baby care and “well-woman visits” are among the procedures covered by this, according to

UHS director Alan Calhoun said that this will be one of the most important changes for UMass students.

If you are one of the almost 14,000 female undergraduate and graduate students that attend UMass, according to U.S. News and World Report, the Affordable Care Act will affect you even more.

You can get pregnant and still expect insurance. The PPACA requires women to be covered by an insurer if they have any pre-existing condition, including pregnancy or a previous pregnancy.

You can pick your OB-GYN. Women getting new insurance can choose any primary care provider, pediatrician or OB-GYN inside of their insurer’s network and/or any emergency care provider outside their network, and it will be covered without a referral.

You no longer have to pay more than a man for healthcare. According to,  a 22-year-old woman could be charged 150 percent more in premiums than a 22-year-old man. As of 2014, there will be price fixing to regulate and make premium costs equal among genders.

Sam Hayes can be reached at [email protected]