Graduate students receive health insurance as part of their stipend. I thought the coverage was good, so I didn’t read the fine print on this policy until I needed an ambulance ride in the spring of 2016. The insurance policy paid only 28% of the $1160 total ambulance bill (they call this the “medicare allowable rate”), and I was “balance billed” for the remaining $830. Both the insurer and the university blamed this on “failed negotiations” with the Philadelphia EMS. I think it’s important for everyone to feel comfortable calling 911 in an emergency without having to worry about surprise bills that can easily run into the thousands of dollars. Union representation would make it easier to advocate for basic medical services like these, which cost the university very little, and ensure that their student-workers have the basic medical care they deserve.
— Graduate Student in the School of Engineering and Applied Science
I would like a union because Penn graduate student workers need health care coverage throughout their time at the University. In 2014, on the advice of doctors from Student Health Services, I sought medical leave for a wrist injury that was preventing me from being able to do extended work on the computer. Unfortunately, when it was granted to me, I had to purchase my own insurance through Obamacare–despite the fact that I was no longer earning a stipend. This is because Penn ceases to provide healthcare to graduate student workers on leave even when they act on the advice of the University’s own Student Health Services.
— Coleman Donaldson, Graduate School of Education
The healthcare referral process is confusing and expensive. Why is it that if I get a referral from my primary care physician it costs $30 but if I get one from a specialist it costs $160? Why is it that no one explains this to you? I spent three hours on the phone fighting this out with the insurance company and still had to pay $160. I’m here to do science not argue with insurance. We need a simpler and more centralized policy for our student healthcare.
— Graduate Student in Biomedical Graduate Studies
Deductibles. Co-pays. Out-of-pocket expenses. Dependent coverage. Non-covered services. Prescriptions. Vision. Dental. These costs, along with navigating the byzantine referral process, create burdens for students who become ill or who otherwise need to draw on the Penn Student Health Insurance Plan for their care. To add insult to (literal) injury, Penn suspends subsidized healthcare for graduate student workers who go on medical leave or receive individual external fellowships. Our ability to do our jobs is hampered by the denial of fair and consistent healthcare coverage.
The current healthcare plan is opaque and inconsistent, which graduate students often discover at the moment when they need it most. The referral process is unclear: graduate students struggle to find providers who can meet their needs and are charged more for consulting specialists. Graduate students have been surprised by hidden fees and lack a centralized source of information about what they can expect.
For graduate student employees who have pre-existing health conditions or who develop serious health issues, the decision to take medical leave often hinges on their financial status rather than their health. Medical leave suspends both one’s stipend and one’s healthcare. Students may, of course, opt to pay out-of-pocket for Penn’s health insurance, which costs nearly $2,000 for one semester or $3,348 for the year. Yet, since medical leave also means that students do not receive stipends, this presents a significant financial obstacle. Students who must take time away from their work in order to treat a serious health issue—whether physical or mental — face a choice between their health, debt, and their education.
Even for student-workers whose stipends include health insurance, coverage only applies to years in which they are fully funded by the University. Student workers in under-funded programs are thus penalized not only by smaller stipends, but also by fewer years of funding, and as a result, limited access to healthcare. EdD student-workers in the Graduate School of Education, for instance, do not receive any health care insurance during their already limited years of funding. In the School of Nursing, graduate students are only guaranteed three years of funding; those who do not have external funding after their third year pay for the health insurance premium while continuing to TA eight hours a week. On Penn’s insurance, such individuals therefore pay $3,348 out of their annual $23,500 stipend —over 14% of their income. While graduate students can serve on the board of Penn’s Student Health Insurance Advisory Committee (SHIAC), this body of unelected members is primarily concerned with overseeing the health care plan for students who are already covered; whether students are covered at all is beyond the scope of this committee.
Graduate student workers must either pay the steep premiums of the University’s Student Health Insurance Plan or seek out their own private insurance, often through the now tenuous Affordable Care Act. Therefore, grad students who take medical leave – or those who can’t afford the steep cost of adding spouses or children to the Penn plan – rely on health insurance that is now under constant political attack. Many family members go without health insurance, but for those who do seek coverage through the ACA, they find that the quality varies widely by state and cost. In Pennsylvania, the less expensive plans all fall under the “catastrophic” category, which tend to have extremely high deductibles.
Many graduate student workers face additional uncertainty when they are awarded individual external fellowships. These fellowships do not always include healthcare in the expectation that our primary employer (Penn) will cover the costs. But Penn often refuses to pay for coverage, placing the burden of payment on graduate students. Some graduate students can appeal through their graduate or department chairs, who may be willing to negotiate with school deans on an ad hoc basis. As a result, our access to healthcare is frequently subjective and is contingent upon our individual department or school, and students who receive the same fellowships might not be covered equally by their employer.
Fair and equitable access to healthcare affects all graduate student workers, and cuts across a range of issues we have identified, including dental and vision coverage, international students, students with dependents, or students who are injured on the job who may not be able to seek care through Occupational Health. Right now, Penn unilaterally sets the terms of our benefits. But a union can work to ensure that students who may not have access to other forms of healthcare coverage, now or in the future, are protected in a binding contract.
GET-UP, as a union of graduate student workers, can fight to secure consistently subsidized healthcare throughout medical leaves of absence and during years on external funding. We can work to centralize and clarify information about coverage, and can support grads who have unexpected healthcare costs by ensuring that their bill reflects fair charges and not failed negotiations.
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