How The SCOTUS Ruling On Health Care Affects College Students

On Thursday the U.S. Supreme Court upheld the bulk of the Affordable Care Act, often referred to as the health care reform law or "Obamacare." The court found a central part of the law, the individual insurance mandate, constitutional, and Chief Justice John Roberts validated the mandate as a tax.

With health care reform free to move forward, there is some good news and some bad news for young people.

Young adults comprise the largest portion of the uninsured. This is partly because they make less money at the start of their careers, and so often forgo the purchase health insurance if they tend to be healthy and expect not to need such coverage any time soon.

Starting in 2014, though, young adults will be required to purchase health insurance or face a penalty from the federal government. They can also opt to remain on their parents' insurance plans until they reach the age of 26.

To find out more about how the Affordable Care Act affects young people, check out the slideshow below:

• Tax Credits For Young Adults

  According to the White House, the ACA "provides premium tax credits for young adults making up to roughly $43,000 a year to ensure that they can afford quality coverage in the new state-based Health Insurance Exchanges which start in 2014." If you don't make enough money to buy your own insurance, you can qualify for the hardship waiver.

• Bans Gender Discrimination, Covers Women's Health

  The ACA bans "gender rating" that allows women to be charged more for the same coverage as men. Women will also have mammograms, domestic violence screenings and birth control covered without a co-pay. And pregnancy is no longer considered a "pre-existing condition."

• No Skipping Out On Insurance

  Since the Supreme Court found the individual mandate constitutional, uninsured young, healthy people who <a href="http://swampland.time.com/2012/06/28/supreme-court-upholds-obamacare-in-landmark-decision/?iid=sl-main-lede?iid=tsmodule#ixzz1z6R1lR7c" target="_hplink">might've skipped out on buying insurance</a> will have to think again. The mandate kicks in in 2014. <em>Time</em> magazine's Swampland blog reports: <blockquote> These people often forgo insurance because they make the fairly good bet they won't incur expensive medical bills and because they don't have enough earning power to afford policies. Young Americans subject to the mandate are expected to pay more into the insurance pool than they get out, to help subsidize the cost of insuring older, sicker people. Standard insurance policies will likely be more expensive for these people under the ACA than they are now. </blockquote> However, this is also why lawmakers built in additional tax credits for young and poor people, and the law now allows 20-somethings to stay on their parents' insurance even after they graduate college -- up to the age of 26.

• Pre-Existing Conditions

  The ACA already prevents insurance companies from charging higher premiums to people under the age of 19 with pre-existing conditions. Going forward, it will forbid insurance discrimination based on pre-existing conditions for everyone, regardless of age.

• Medical Students Get Help On Student Loans

  The ACA gives <a href="http://campusprogress.org/articles/five_ways_the_affordable_care_act_helps_young_americans/" target="_hplink">financial support</a> for the $12 million National Health Services Corps Students-to-Service Loan Repayment Program, which will provide medical school graduates up to $120,000 to repay outstanding loans if they agree to work as primary care doctors in under-served communities. Campus Progress reports: <blockquote>The ACA also creates a Prevention and Public Health Fund, which will help create new positions for primary care doctors, fund training programs for physicians' assistants and nurse practitioners, and push states to invest in health care training and job creation.</blockquote>

• The 80/20 Rule Will Improve Campus Health Plans

  Most college health centers don't allow students to use outside insurance plans, however, the services they provide will improve. According to <em><a href="http://www.usnews.com/education/articles/2010/09/09/5-ways-health-reform-affects-college-students" target="_hplink">U.S. News & World Report</a></em>: <blockquote>Effective Jan. 1, 2011, all insurance plans must have a medical loss ratio that is at least 80 percent to 85 percent (depending on the plan's size). That means that at a minimum, 80 percent to 85 percent of all premiums paid by policyholders must in turn be used to provide medical care.</blockquote> Many schools had loss ratios closer to 50 percent prior to the law, but increasing that loss ratio means they're providing more through coverage. In other words, it's the "<a href="http://www.whitehouse.gov/healthreform/relief-for-americans-and-businesses#young-adults" target="_hplink">80/20 rule</a>": insurance companies (and colleges providing health services) must spend at least 80 cents of your premium dollar on your health care or improvements to care. Insurance companies must also publicly justify their actions if they want to raise premiums by 10 percent or more, according to the White House. The reform law also bans insurance companies and colleges from placing lifetime caps on coverage.

• Preventative Services Are Covered

  If you're healthy and work to stay healthy, you can avoid more dramatic health issues down the line. A large number of <a href="http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html" target="_hplink">preventative services</a> are now covered thanks to the ACA, but a few are worth pointing out for college students: Alcohol misuse screening and counseling, Depression screening, Type 2 Diabetes screening, HIV screening, immunization vaccines, STI prevention counseling, tobacco use screening and intervention, cervical cancer screening and contraception coverage.

• Aim To Improve LGBT Community Health

  Under the ACA, there will be <a href="http://www.americanprogress.org/issues/2012/03/aca_top_10_lgbt.html" target="_hplink">data collection to better understand LGBT</a> health disparities, and increases the National Health Service Corps, which offers LGBT cultural-competence training to corps members through the Department of Health & Human Services.

• Young People Can Stay On Their Parents' Insurance To Age 26

  Prior to the Affordable Care Act, <a href="http://www.ncsl.org/issues-research/health/dependent-health-coverage-state-implementation.aspx" target="_hplink">37 states provided</a> some form of this type of coverage for young adults -- some more generous than others. The U.S. Department of Health & Human Services estimated in 2010 that this portion of the bill <a href="http://www.americanprogress.org/issues/2012/01/aca_success.html" target="_hplink">affects 2.37 million people</a>, of which 1.83 million were uninsured.

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