In addition, some college students may obtain coverage through  public health insurance programs, such as Medicaid or the State Children’s  Health Insurance Program (SCHIP). Under federal law, college students who have lost eligibility for dependent  coverage under a parent’s employer-sponsored insurance plan may be able  to use provisions in COBRA to continue their health insurance for a  limited period of time. Specifically, about 42 percent of  nonstudents aged 18 through 23 were uninsured in 2006. Certain Groups, Including Part-time Students and Older Students, Were More Likely Than Others to Be Uninsured in 2006

Of the 1.7 million college students aged 18 through 23 who were uninsured  in 2006, certain groups of students—including part-time students, older  students, and students from families with lower incomes—were more  likely than others to be uninsured. 2.) These differences  among uninsured college students from different regions are consistent  with characteristics of the uninsured found in the general U.S. population. Over Half of Colleges Offered Student Insurance Plans in Academic Year 2007- 2008, and These Plans Were Customized and Plan Benefits Varied

Over half of colleges nationwide offered health insurance plans to their  students in the 2007-2008 academic year, and these plans were customized  and benefits varied across plans. Student Insurance Plans Were Customized to Reflect Colleges’ Priorities, and Plan Benefits Varied

Student insurance plans were customized to reflect colleges’ priorities in  making health insurance premiums affordable for their students while at  the same time providing coverage that meets the needs of students. For example, some plans we reviewed charged relatively low  annual premiums—$30 to $200. These plans also set relatively low limits  on the amount they pay for covered services—with some having limits as  low as $2,500 for each illness or injury. The benefits offered by student insurance plans varied in terms of the  services they covered and the extent to which they paid for or limited  payment for covered services. 6.) Colleges and States Have Taken a Variety of Steps to Increase the Number of Insured College Students

To increase the number of insured college students, colleges and states  have taken a variety of steps, such as requiring students to have health  insurance. Some States Have Expanded Dependents’ Eligibility for Private Health Insurance

Some states have expanded dependents’ eligibility for private health  insurance, and because most college students obtain health insurance as  dependents, this effort has made health insurance more available to  college students. External Comments

We provided a draft of this report to ACHA, an advocacy and leadership  organization for college and university health. ACHA officials provided a  technical comment, which we incorporated. Appendix I: Scope and Methodology

We examined (1) the insurance status of college students,   (2) characteristics of uninsured college students and the financial impact  of this population on health care systems, (3) the extent to which colleges  offered student insurance plans in the 2007-2008 academic year and the  characteristics of available plans, and (4) efforts to increase the number of  insured college students. The  supplement also gathers data on demographic characteristics. Availability and Characteristics of College Student Insurance Plans

To describe the extent to which colleges offered student insurance plans  and the characteristics of available plans, we collected data on student  insurance plans offered at a random sample of 340 colleges. We reviewed plan and policy documentation  available for each college plan, and interviewed officials from each college  regarding their college student insurance plan and policies.
Why GAO Did This Study

College students face challenges obtaining health insurance--they may not have access to insurance through an employer, and as they get older, they may lose dependent coverage obtained through a parent's plan. Federal law ensures continued access to health insurance for some, but not all, such students. Without health insurance, college students may be unable to pay for their health care, and the cost of this care may be passed on to federal and state payers, such as Medicaid. College students may have access to student insurance plans offered by their colleges. GAO was asked to report on uninsured college students, student insurance plans, and efforts to increase the number of insured students. GAO reviewed (1) college students' insurance status, (2) uninsured college students' characteristics, (3) the extent to which colleges offered student insurance plans and the characteristics of available plans, and (4) efforts to increase the number of insured students. GAO analyzed data from a national survey on college students' insurance status and uninsured college students' characteristics. GAO collected data from 340 colleges on the availability of student insurance plans and the characteristics of available plans, and also gathered detailed plan information from case studies of 10 colleges and interviews with experts and insurance industry officials. GAO also reviewed some states' laws.

What GAO Found

About 80 percent of college students aged 18 through 23 had health insurance in 2006. While 67 percent of college students were covered through employer-sponsored plans, 7 percent were covered through other private health insurance plans, such as student insurance plans, and 6 percent were covered by public programs, such as Medicaid. Most insured students were covered, for example, as a dependent, on a policy under another person's name. About 20 percent of college students aged 18 through 23 (1.7 million) were uninsured in 2006, and certain groups of students--such as part-time students, nonwhite students, and students from families with lower incomes--were more likely than others to be uninsured. The characteristics of uninsured students are consistent with those of the uninsured found in the general U.S. population. Over half of colleges nationwide offered student insurance plans in the 2007-2008 academic year, and plans' benefits varied. Colleges customized their plans to reflect their priorities in making premiums affordable for students while providing coverage that meets students' needs. The plans GAO reviewed varied in the services they covered and how they paid for covered services. Specifically, some plans excluded preventive services from coverage and some plans limited payment for benefits such as prescription drugs. In addition, plans also varied in terms of premiums and maximum benefits, with annual premiums ranging from $30 to $2,400 and maximum benefits ranging from $2,500 for each illness or injury to unlimited lifetime coverage. Colleges and states have taken a variety of steps to increase the number of insured college students. For example, GAO estimated that about 30 percent of colleges nationwide required students to have health insurance in academic year 2007-2008, and some states also have health insurance requirements for college students. Finally, some states have expanded dependents' eligibility for private health insurance, which makes insurance more available to college students who obtain coverage as dependents. Officials from the American College Health Association (ACHA)--an advocacy and leadership organization for college and university health--provided a technical comment, which we incorporated.