“We do have lots of students with chronic health issues, so making sure that they had good coverage was really important.”

I met with Jennifer Combes in the staff office located at the back of the Student Health Center of Kalamazoo College. We sat in high backed office chairs while Jennifer finished up some work on the computer before turning towards me.
Jennifer Combes is the office coordinator for the Student Health Center. You’ve most likely interacted with her if you have been to the health center for an appointment, greeted by her when you go to check in. Besides checking people in to appointments and scheduling students, she is the campus expert on the Kalamazoo College Student Health Insurance plan. She can answer any question that students or parents may have about all the services that are covered by the insurance plan and those offered at the Student Health Center. Jennifer has a wealth of information about the insurance plan which made her the perfect candidate to discuss this project. She is able to give a unique perspective about how the health of the students of Kalamazoo College would be affected by the reforms and changes made by the Affordable Care Act.
I first asked her to tell me about how the insurance plan offered by the school had changed over time. She stated that three years ago the College had a plan that was extremely reasonable but offered little coverage. She mentioned a student who had “been denied for a claim on her physical therapy, which she had been refered to get by her doctor.” Jennifer said that case and many others like it, inspired the College to find a new insurance company. At this time “the Affordable Care Act was just beginning to take hold”, and “we knew we needed a new plan.” This was necessary as Jennifer said, “Students are young and generally healthy, but we do have lots of students with chronic health issues, so making sure that they had good coverage was really important.”
With the new plan and the expansion of care by the ACA, the Student Health Center is now able to offer many more preventative care services at little to no cost to students. According to her, “No insurance companies have to pay for routine immunizations, STD testing, birth control, preventative exams (like physical exams), and other testing based on the type of risk category it is in and the student’s family history.”
She says the main problem with the ACA is that insurance companies can write their own rules to regulate how much they pay. She said, “An example is an individual going to get an immunization at their primary care doctor. That immunization is covered at 100%, but if that person goes else where it may only be covered at 60%.” This is the same for birth control, which has to be covered at 100%, but insurance companies may regulate how many packs you can get at a time, or what type of birth control you get.
With so much variation between insurance plans, Jennifer stressed the importance “of knowing exactly what your plan covers” so all students can get the services and care they need. She stated that during freshman orientation the Health Center does offer a workshop for parents and students to understand the insurance provided by the school, but with so many other events going on during that time, it is often an event that is overlooked. Jennifer said that she hopes that in this coming school year, they will be able to offer more workshops not just during freshman orientation, but throughout the year so all students will be able to understand their coverage and how the ACA has changed it.
The biggest changes that the Health Center has experienced because of the ACA is in the cost of the services they offer. They are now able to offer most students birth control at no cost, when it used to be $15, and for Gonorrhea and Chlamydia STD testing which used to be $250 is also now free for most students. Jennifer stated, “This is a huge barrier reducer, it allows so many more students to get the testing, when they may have not in the past because of the cost”. The Health Center expects to see many more students come in to take advantage of these preventative care services.

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