UC System May End Health Care Caps, Making New Bill Moot

A bill introduced last week, AB 314 by Assembly member Richard Pan (D-Sacramento), would eliminate fiscal caps on medical care for University of California students.

UC officials said they’re considering their own internal proposal to erase the caps, which would make the proposed legislation moot, but bill author Pan said he plans to go ahead with the legislation to ensure the rule is changed.

“It’s only fair that [UC students] should have the same protections as the rest of California,” Pan said, referring to provisions in the Affordable Care Act that prohibit lifetime caps on care. Even people in high-risk insurance pools had lifetime caps lifted last year.

But, Pan said, federal regulations do not extend to state education health plans. The coverage cap for UC students currently is set at $400,000. Students who get seriously ill or injured and exceed that cap need to pay out of pocket for their care. That’s what Pan wants to change with his new bill.

The UC system may want to change it, as well.

According to Brooke Converse, a spokesperson for the UC’s Office of the President, the issue has only recently been raised. UC officials hope to make a decision quickly.

“It’s so new, we haven’t even had a chance to analyze it yet,” Converse said. “There were questions raised about it a few weeks ago [in] the health plan advisory committee.” The issue also was broached at the mid-January meeting of the UC Regents, Converse said. Those concerns have prompted an internal discussion that should be resolved soon, she said.

“We should have recommendations to the executive steering committee pretty soon, and I think we’ll have a decision by the end of May,” Converse said.

If Pan’s bill clears committees, that’s just about the time the proposed legislation would be up for a floor vote.

The numbers are relatively small, she said: “In plan year 2011-12, five students reached the lifetime coverage cap,” she said. Converse did not have numbers on the students last year who reached a different cap, on prescription medications.

The low number of people affected by the cap argues in favor of removing it, according to Kenya Wheeler, a UC Berkeley graduate student who is at the center of this controversy because he passed the lifetime cap after being diagnosed and treated for brain lymphoma.

He said one of the tenets of the Affordable Care Act is to spread risk across a wider spectrum of people. He said the 140,000 students in the UC system is a big risk pool for the few students who exceed the cap.

“UC is ignoring the mandate of the ACA to change,” Wheeler said. “Students shouldn’t have to fight two battles, first to save their life, and then to get medical coverage.”

Related Topics

Capitol Desk Insurance The Health Law