Despite the March 7 Herald editorial stating that most students already have insurance, numerous studies have indicated that 20-25 percent of university students are uninsured and that another 20-25 percent are underinsured.

Underinsured is defined as having health insurance that is extremely limited in its scope of coverage (e.g. student is on parent’s “managed-care organization” plan back home that only provides emergency or life-threatening coverage while “out-of-area” in Madison).

Significant proportions of students who withdraw do not have the safety net of adequate health-insurance coverage. “Access to health care” is identified as one of the top 10 leading health indicators by the Centers for Disease Control and the U.S. Surgeon General’s Office. Students’ health is enhanced by access to year-round, comprehensive and affordable health insurance.

UHS and ASM have listened to the many voices of students struggling with this reality and are working with their colleagues and constituents to change the system to ensure all students have access to affordable and comprehensive health-care coverage.

Insurance is meant to pool comparable risk across a population, insuring against unplanned events. The critical problem with the current SHIP Domestic Plan is that voluntary enrollment systems lead to strong adverse selection, bad risk pools and a 5 percent average participation rate.

This results in high utilization of health-care services, dramatically increased insurance premiums, substantial cost shifting (high co-pays and deductibles), restrictive benefit packages and further declines in participation rates. Insurance carriers also recognize this extreme risk and are withdrawing from the voluntary student-health-insurance market in droves. Instead of providing all students access to the safety net of affordable and comprehensive health-care coverage, we provide an expensive, restrictive plan that fewer and fewer students see value in.

Something needs to be done—and soon. I will attempt to briefly respond to each option presented.

Marketing. No amount of aggressive or creative marketing will change the fundamental enrollment dynamics of a voluntary plan. All public and private insurance experts recognize this fact. There are numerous voluntary enrollment plans in the field. I challenge anyone to find a plan with a substantially higher participation rate and a more diverse risk pool. If there was a marketing solution to this problem, we’d all be replicating that program. Having said that, SHIP Manager Linda Hammer has developed one of the most strategically creative and multifaceted educational outreach and marketing efforts in the college-health field. UW System Consortium Plan. The consortium plan is a step in the right direction.

There is value in expanding the student-enrollment pool, centralizing and consolidating administrative support functions and expanding health-care system access for students across the state. However, a voluntary consortium plan will only combine very small, high-risk pools into one slightly larger, high-risk pool and not address or solve the fundamental problem. Insurance experts tell us that the enrollment numbers will not approach the level necessary to offset the adverse selection effects (law of large numbers, in insurance-speak).

The only long-term solution is an automatic enrollment system with an opt-out option. The value of this system is that over 30 percent of students remain enrolled in the program, adverse selection is reduced, the larger pool absorbs the risk, premiums drop significantly and benefit packages are expanded. For the minor “cost” of having to check a box on your tuition bill stating, “thanks, but no thanks,” you provide your fellow students who desperately need this health insurance safety net, access to more affordable and comprehensive coverage.

Total health-care costs for students are further reduced due to the negotiating leverage this larger enrollment pool can exert on the marketplace. Health-care charges will drop an additional 10-20 percent through negotiated fee discounts with preferred provider networks.

Success based upon deceiving students? Again, these plans exist all across the country; many have been in place for decades. Find one school where the students feel the success of the program based upon deceiving them, dishonestly hiding their opt-out option, not fully aware of their school’s health-insurance requirement and their options to waive out. ASM has taken a strong stance that students will develop the notification processes, utilizing a multitude of technological venues and strategies. If students do not want this coverage, they will know how to opt out.

Do students need the coverage? Once again, I suggest you check those plans across the country. Each plan is extensively utilized due to the overwhelming need.

Ask your fellow students who thought they didn’t need it, who thought they were young and healthy, who thought they wouldn’t need to see that specialist or have that expensive diagnostic test performed, who thought they wouldn’t get pregnant, who thought they wouldn’t have that accident or injury, who thought they wouldn’t need to visit the emergency room or who thought their parents’ plan would cover them.

You may not need this coverage, but many of your fellow students do need access to the most affordable, comprehensive plan possible to ensure their academic and intellectual investments. What “price” will you make all students pay?

The choice is up to each and every student. This enrollment proposal is for students, by students and can only succeed with strong student support.