CSU Insurance Enrollment Project Reports Dramatic Reductions in the Numbers of Uninsured CSU Students

Effort Spearheaded by Cal State L.A. Serves as National Model

Los Angeles, CA -- The number of uninsured students on the 15 largest CSU campuses has been reduced by approximately 60%, from about 100,000 (25-30% of students) before Covered California open enrollment to about 40,000, as of May, 2014. This reduction leaves just 10% of students on these campuses still uninsured, according to a new poll taken by the CSU Health Insurance Education Project.[1] 

“This is Commencement Week at Cal State L.A.,” said the university’s president, William A. Covino.  “While we don’t know where all our graduates are going from here, we do know that many more of them will have health insurance coverage when they get there.  And that is something that we can all feel good about.”

President Covino also read a congratulatory message from CSU Chancellor Timothy White.

The 15 campuses on which the project placed student staff to educate students about the Affordable Care Act and Covered California constitute 87% of the total CSU student population of about 447,000. The 23-campus CSU system is the largest university system in the nation.

Poll results also reveal that about 1/3 of CSU students on the 15 staffed campuses signed up for Covered California or Medi-Cal. Additionally, one-third of all student respondents reported that at least one family member signed up for Covered California or Medi-Cal.   

In total, the poll reveals that approximately 260,000 students and family members signed up for one of the two programs.[2]  

The Project conducted polls on seven of the 15 staffed campuses. The demographics of the eight campuses that were not polled are very similar to the seven campuses that were polled. Additionally, project efforts on all 15 campuses were nearly identical. Therefore, it may be safe to assume that the numbers of students enrolling in insurance and the reductions in the numbers of uninsured students were similar on the eight non-polled campuses. The total number of students polled was 1,971. Efforts were made on each campus to have the poll on that campus accurately reflect key campus demographics.

According to project director Walter Zelman, chair of the Department of Public Health at Cal State L.A., “For a population of young, largely lower-income adult individuals, a rate of just 10% uninsured is unheard of in California.”

The 60% reduction in the number of uninsured individuals in the CSU student population is strikingly high compared to findings in other recent studies. For example, a Gallup poll from April-May 2014 reported a 26% reduction in the number of uninsured individuals nationwide, from 18% to 13.8%.[3] The California Simulation of Insurance Markets by researchers at UCLA and UC Berkeley projected a reduction in the number of uninsured Californians by 2014 of just over 18%.[4]

Project Director Zelman suggested that a number of factors may account for the greater reductions in the numbers of uninsured individuals on CSU campuses. These include: the strong leadership role played by CSU Chancellor Timothy White; the intensity of effort devoted to educating the student population; the support of many university administrators, student health centers and faculty; the high concentration of uninsured, low-income young adults on CSU campuses; the unique access that the project had to students; the availability of sizable premium assistance through Covered California; and the new Medi-Cal rules that allow access to Medi-Cal for single adults.

The CSU Health Insurance Education Project is an education and outreach program housed at Cal State L.A. and funded by a grant from Covered California. The project placed student educators on the largest 15 CSU campuses. Between August, 2013 and May 2014, the project spent about $600,000. In that time frame project representatives gave about 1500 classroom presentations to about 60,000 students, and conducted about 70 forums attended by over 3,000 students. More than 300 enrollment events were conducted, reaching over 7,000 students and family members. The project also employed mass emails from university officials and organizations such as financial aid offices and student health centers. Many other education and outreach tools were also employed.

The poll of seven campuses also found that:

  • Seventy-one percent of students had a somewhat or very positive view of Covered California.
  • Forty-five percent of those signing up for Covered California said that the primary reason they signed up for insurance was that it was now affordable
  • Fourteen percent of student respondents reported signing up for Covered California; twelve percent reported new enrollment in Medi-Cal; eight percent said they had signed up for Covered California or Medi-Cal and were waiting for final approval. 
  • Latino and African American students are more likely to be uninsured (13% and 12%, respectively) than whites (8%) and Asian Americans (9%).
  • The percent of Latino students reporting themselves to be uninsured fell dramatically, from an estimated 42% in September, 2013 to 13% in May, 2014. 
  • The percent of uninsured students also decreased for Asian/Pacific Islanders (from 19% to 9%), African Americans (from 23% to 12%), and whites (from 21% to 8%).
  • Cal State L.A. had the highest percentage of students still uninsured (19%);

San Jose (8%), Northridge (7%) and Fresno (7%) had the lowest percentages.Cal State L.A. had the greatest percentage of Latino students and very low-income students. Both of these groups have relatively high percentages of uninsured individuals.

  • Of the 10% reporting themselves as uninsured, less than 10% said they were uninsured because “I don’t want insurance.” As the other 90% reported being insured or having applied for insurance, this suggests that just that just one percent (10% of 10%) of respondents did not want insurance.
  • The most common explanation (24%) for being uninsured was that “I did not know enough about insurance or how to get it.” 
  • Two-thirds of students reported talking to others about getting health insurance during the open enrollment period. Forty-eight percent reported talking with family members, a fact which may partly explain the sizable amount of reported enrollment of family members.  Only 33% of students did not talk to anyone about health insurance.

Project Director Zelman said that in putting all the findings, numbers and project experiences together, one conclusion stands out above all others. “The issue is not invincibility, it is affordability. Students know they need insurance. Provide them with insurance they can afford, and offer them some education about it, and they will sign up. Judging from our efforts and those of Covered California, the potential of the Affordable Care Act to reduce the numbers of uninsured young Americans is substantial and perhaps still untapped.”

Zelman also noted that the large number of students enrolling in Covered California should help Covered California keep insurance premiums affordable. He suggested that a larger Covered California would produce more market power, and a younger and healthier pool of insured individuals should quell concerns that Covered California’s insurance pool will be disproportionately older, sicker, and more expensive. Therefore, Zelman suggested, large premium increases should be both less likely and much harder to justify.

Zelman also expressed the hope that the apparent success of the CSU project might inspire other state university and community college systems to undertake similar efforts. “These student populations may be the low-hanging fruit in reducing the numbers of the uninsured and keeping insurance pools healthy and low-cost.”

Zelman also read a congratulatory message from Peter Lee, Executive Director of Covered California. Mr. Lee noted that “It has been a pleasure partnering with CSU leaders and students in educating CSU students about their new health coverage options. Getting young Californians enrolled in health care coverage has been a primary goal of Covered California and speaks to our core mission of ensuring that California's diverse population has fair and equal access to quality, affordable health care. The recent survey conducted by Cal State Los Angeles appears to be a strong indicator that students want, and know they need, health insurance. 

I send my heartiest congratulations to Chancellor White, the project’s leadership team at Cal State L.A., and to the many students and peer educators who worked so hard to educate so many.”

Campus-specific data for the seven CSU campuses polled and a chart pack are available here: http://www.calstatela.edu/sites/default/files/users/u10891/data_7_campuses_6-11-14b.xls and http://www.calstatela.edu/sites/default/files/users/u10891/press_conference_slides_june_2014_es.pdf.

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[1] The number of students uninsured in September 2013, is estimated to be 25-30%. This estimate is based on a project poll taken on 3 CSU campuses in fall of 2013, prior to Covered California open enrollment. The 25-30% estimate compares favorably to the percentages of uninsured 18-24 year olds in a 2012 California Healthcare Foundation survey. That survey found 21.2% of 18-20 year olds uninsured and 30.3% of 21-24 year olds uninsured. Given the lower-middle to lower incomes of the CSU student population the percentage of uninsured CSU students in 2012 was probably closer to 30 than 25. The fall CSU poll surveyed 836 students on 3 CSU campuses –Cal State L.A., Fresno, and San Jose. Percentages of uninsured on the campuses were; Cal State L.A. 35%, Fresno 33% and San Jose 21%.

[2] Assumes each student represents a family and that one family member, other than the student, enrolled in Covered Ca or Medi-Cal.

[4] UCLA Center for Health Policy Research “California Simulation of Insurance Markets (CalSIM)”, Version 1.8: http://healthpolicy.ucla.edu/publications/Documents/PDF/2014/calsimdatab...

 

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6/12/14