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Experts work to clarify how ACA implementation will affect college sports

By Brian Hendrickson
NCAA.org

Answers are starting to rush in to Jeff Hadden’s office, arriving at a rate of three or four per week since the presidential election. But it still doesn’t compare to the pile of remaining questions.

All those questions – and the burgeoning answers – are regarding the Patient Protection and Affordable Care Act (ACA). The monumental health-care legislation, which aims to revolutionize health-care coverage in the United States, is little more than a year away from its scheduled implementation date to offer insurance coverage to individuals through new exchange programs.

Many questions remain as schools grapple with the future of student health plans, examine new options for providing student-athletes with required coverage and consider legislation to address funding. The weekly clarifications that Hadden, a human resources consultant for LHD Benefit Advisors who works with the NCAA’s national office, receives from the Department of Health and Human Services are starting to chip away at the many questions. But they’re only a start.

And that’s the challenge facing NCAA leaders as they look to guide members into an uncertain future: How can they best position themselves for change when they don’t know exactly what it will look like?

Juanita Sheely, NCAA director of travel and insurance, has been sharing information with membership committees since October. The key message is that each campus will need to consult its general counsel and risk managers to evaluate the impact, which could vary from state to state and athlete to athlete.

Sheely’s PowerPoint presentation provides a high-altitude view of the law’s elements. It explains how the exchanges are being developed to sell individual health-care plans − what Hadden describes as “the Expedia of health care,” where customers log in to a website and select from several tiers of plans in a retail format. It also explains how health-care reforms are expected to alter the fundamentals of traditional plans and how employers might be affected.

For example, universities for years have offered health-care plans to their general student population, which could also be used by student-athletes. But the early implementation of ACA has already led some universities to consider dropping those plans.

The ACA will allow students to remain on their parents’ health-care plan until age 26, an increase from age 22, which could reduce the demand for those student health plans. And new coverage mandates in those plans have increased the cost by up to 200 percent at some universities for which Hadden consults. It’s already prompted three of Hadden’s university clients to drop their student plans.

That creates a significant problem in Division II, which has a permissible benefit bylaw that prohibits schools from paying for student-athlete insurance plans that aren’t offered to the general student body. Should the student plans get dropped, what options would be left for the student-athletes?

That question has prompted Division II to develop emergency legislation that will be considered by the Division II Presidents Council at next month’s Convention. The legislation would deregulate health-care provisions in Division II as outlined in Bylaw 16.4 and provide enough flexibility for schools to adjust to the law as it evolves.
Division I will also put similar legislation to a vote next month as part of its reform effort, which would expand medical expenses for which schools are allowed to pay.

“Let’s give them that flexibility,” said Dan Kenney, a member of the Division II Legislation Committee and former athletics director at UNC Pembroke. “It’s just telling them that they have the flexibility that, if it becomes part of their strategic plan, that it lets student-athletes have some protection.”

For example: A student-athlete could stay on the insurance plan their parents obtain through their employer until age 26. But some of those parents may lose that coverage if their companies cut their staffs below 50 full-time employees – the threshold at which they are required to offer all of their employees health insurance. Some companies have already made national news by threatening cuts to avoid paying that bill, which in turn would force some student-athletes to find individual coverage through the state exchanges.

But those exchanges will look different in each state, Hadden said, and nobody is sure yet how they will function. States first must first decide whether they will develop their own exchange or leave it to the Department of Health and Human Services to develop it for them. The process may not become clear for several more months.

The changes could also provide helpful options, though. Universities that continue to offer student health plans could look at ways to package those plans with the existing accident insurance student-athletes are required to carry. The bigger pool of participants might be useful as leverage to negotiate a lower-cost plan.

“There’s a whole lot of things at play,” Sheely said. “It’s important for them to kind of look at what they’re doing instead of saying, ‘Well, this is how we’ve always done it.’ It’s potentially the opportunity to get better coverage, maybe at a lower cost.”

To assist those discussions, Sheely and Hadden are currently collaborating on a list of frequently asked questions to help guide members through the developments and understand the significance of the changes. Sheely hopes to have the FAQ document completed in time to circulate at the January Convention and through direct mailings early next year.