>Medicaid is a federal and state program that assists low-income individuals and families to cover medical expenses. According to the Kaiser Family Foundation, nearly 7 million people are enrolled in the New York State Medicaid, and one out of four adults ages 19-64 are Medicaid members.
Ironically, there’s a particular group of individuals that has been losing their Medicaid coverage, for a unique reason: low-income students, who are currently attending college out of state, are seeing their Medicaid being invalidated after purchasing their school’s mandatory health insurance.
These students, who previously relied on Medicaid for medical assistance, can no longer access it due to legalities that terminate Medical coverage when an individual adopts insurance out of state. As a result, students who frequently travel between home and campus often find themselves in perplexing situations where they’re uninsured, putting them at a risk for significant health and financial challenges.
Discovering Loss of Coverage
Many students mentioned a lack of notification regarding how enrollment in school health insurance policies could jeopardize their Medicaid coverage back in New York State. Frequently, they don’t discover the loss of coverage until they enter college and begin utilizing the school’s healthcare system.
Manda Bah, a senior at George Washington University (GWU), recounted her experience when she attempted to book her first appointment at the Student Health Center, where she thought she could use her New York MetroPlus Medicaid. “They had to explain to me, ‘No, you are actually enrolled into the GWU insurance,’” she said. “I didn’t think it was a big deal until I [went] back to New York to continue my medical appointment.”
Julie Lam, a junior at Boston’s Northeastern University (NEU), faced a similar issue during the summer of her sophomore year while attempting to renew her Healthfirst Medicaid. “They saw that I had Blue Cross Blue Shield,” she said. “They’re like, ‘That health insurance overrides your Medicaid.’” Because Lam visits New York quite often, she made multiple calls to both her insurance provider and NEU’s health center in response, to try to find a solution that wouldn’t disqualify her from New York State Medicaid. “I was angry,” Lam said. “They were throwing me around like soccer [without a solution].”
Healthcare Delays and Financial Burden
During the summer of her junior year, Bah faced significant delays in accessing healthcare when she returned to New York to see a specialist for her gastrointestinal issues. After losing her MetroPlus Medicaid while residing in Washington D.C., she needed to regain her coverage to seek professional help in New York. “I had to wait about two months to get it activated, and then schedule the appointments to see a specialist,” she said. “[Then] I saw the specialist and received a two weeks treatment, [but then] I had to come back here to D.C.”
While Bah encountered delays in requesting medical help, Lam struggled with significant financial burdens. The Blue Cross Blue Shield health insurance doesn’t offer the assistance she needs the most: dental care. “I normally use my coverage more for eyecare and dental,” Lam said. “But then it doesn’t cover dental, [unless] you’re under 18.”
Last summer, she experienced a severe toothache, prompting her to return to New York to see her dentist — a visit which cost her $200. Although her toothache was alleviated after that visit, it returned again later on in the semester. The options left for her were limited: she could either return to New York, or try to find a dentist in Boston. Without Medicaid coverage, she felt it wouldn’t be worth the time and effort to return to New York, especially because she assumed the costs in Boston would likely be similar.
However, after visiting a dentist in Boston, her medical bill amounted to $2200. “It was [stressful],” she said. “I need to rethink my basic spending and allocate them for this treatment [when] I didn’t have this money to begin with.”
Inconsistent Therapy
The lack of access to New York State Medicaid has also resulted in some students experiencing inconsistent psychological therapy.
Grace Lum, a sophomore at California College of the Arts (CCA), shared their struggle to find a consistent therapist after moving to California for college. “I had a therapist before I went to college, but she wasn’t my therapist anymore because I was moving out of state,” Lum said. “[But] I need weekly therapy, and need a consistent therapist to build a relationship with.”
Lum waived the Aetna insurance that CCA provides to students, as it didn’t cater to their specific needs for psychological therapy. Eventually, it became a financial burden when they had to pay $250 out of pocket for each therapy session. “It was really frustrating,” Lum said.
When Lum returns to New York during school holidays, accessing psychological assistance continues to remain a challenge without Medicaid. “When you apply for these health care [plans], it takes more than six weeks to get insured, and by that time, I have to go back to California,” Lum said. “But a lot of the things that I need are because of my circumstances living in New York.”
Challenges in Seeking Alternatives
Unlike Lum, who ultimately switched to California’s Medicaid Program, Medi-Cal, to fulfill their specific needs, Lam’s attempt to make a similar switch proved unsuccessful. When she learned that she could apply for Massachusetts’ Medicaid Program, MassHealth, it was already too late. Lam is currently participating in NEU’s Cooperative Education Program, working full-time only during this semester, which makes her ineligible for MassHealth.
The income guidelines require a single individual to have an annual income below or equal to 138% of the Federal Poverty Level, which is approximately $20,791. However, with her work income, the MassHealth system detects her as exceeding the threshold. “I have an income from the co-op that goes beyond the margin by 200%,” she said. “[However,] my income is [only for] half a year, but they’re foreseeing that I’ll make more.”
Hoping for Change
All three students expressed that their schools’ health insurance plans do a great job of providing affordable and comprehensive coverage options, but that they are hoping for a more inclusive policy that would allow them to access healthcare in both their home states and current states of residence. “I want to do everything in New York after graduation,” said Bah. “I didn’t see an incentive to transfer everything to Washington D.C., because I didn’t want that [hassle].”
Lam also foresaw a similar future for herself. “I’m used to seeing all the doctors in New York [because] they’re familiar with my medical records,” she said. Even though I [could] transfer my medical records to Massachusetts, I still trust the doctors more in New York.”
Without a solution that could address the specific needs of low-income college students, who previously relied on Medicaid but can no longer access it after moving out of state, many are left facing increased financial burdens and stress when transitioning between college and home. “This is just a very unique college student problem because they are moving in and out of state,” said Lum. “There should be a policy for all college students nationwide.”