As the North Carolina General Assembly moves forward with plans to declare parts of the federal government's recent health care bill unconstitutional, political debate continues about the legitimacy and future of the controversial policy.
Along with Florida, Virginia and other states, the assembly has stated the part of the bill requiring people to buy coverage is not founded in constitutional principles. Amidst the politically charged rhetoric and debate, where accurate information is difficult to obtain, one question is prevalent across college campuses: What does this mean for college students?
Breaking down the bill
"Of all the groups who have benefited from this legislation, students are the people who have overwhelmingly done best," said Betty Morgan, associate professor of political science.
Students in the 19-24 age group are the largest uninsured group in the United States. Through the bill, universities are now required to provide credible health insurance policies for students who don't fall under their parents' policies, rather than the minimum-level coverage that was characteristic in the past.
Another provision allows students to remain on their parents' health insurance plan until the age of 26, according to Katy Rouse, assistant professor of economics.
"Before, when you graduate college, you're on your own," she said. "The nice thing is that (students) no longer have the added pressure of finding a job with benefits right away."
Research has shown that in the first 10 years after graduation, the average undergraduate student will have about 12 jobs, Morgan said.
"We're not sticking very well and part of that imperative is you need a job to have insurance," she said. "But that is no longer the case, so you can make good decisions about job options. Students (that) age have benefited exponentially."
Clarifying the contention
Morgan said she doesn't understand why students are not more vocal about defending the bill, as they are the biggest beneficiary group.
"(Students') lives have had a magic wand waved over them and no one is even talking about that," she said. "Part of it is politics of disinformation, overheated rhetoric and misinformation that has made it difficult for any of us to get a good grip on what's going on."
In some cases, powerful political groups that argue at the behest of the health care industry have captured the argument, distorting the debate. The nature of the bill also makes it a hard policy to promote in the American political arena, Morgan said.
"We call it redistributive policy and any time you have that, you're taking something significant, of value and redistributing it in a different way from people who have it to people who don't," she said. "It always requires significant amounts of personal attention, lots of visibility by important political players and expenditure of lots of political capital. It's perceived as taking something away from someone else."
In this case, what's being redistributed is access to health care. Despite continued debate between Republicans and Democrats, Morgan said policy-insiders are beginning to admit the reality of the bill.
"These people who have, for years, worked on the positioning of making it sound absolutely horrible if it comes to be, those people are now stepping out and saying it was never true," she said. "The debate has been captured by moneyed insider interests who have gone out to completely confuse the debate."
Considering the consequences
Greg Lilly, associate professor of economics, said while Republican politicians are arguing that the bill will increase costs and protesting Democrats' assumptions that it won't, it's impossible to predict the eventual economic outcome of the bill.
"The (political parties) have their economists saying this and that, but there is not a side that has 95 percent of the economists on their side so I take that to mean they're not really sure, " he said.
What Lilly said he can foresee is a minimal increase in costs for states, including North Carolina. The federal government will pay for the provisions of the bill until 2014 and continue paying 90 percent of the expenses until 2020.
"The states don't have to worry about anything immediately," he said. "I'm pretty sure the economy will recover by then, the state of North Carolina will be in a better financial shape by then and the federal government promises to slowly give the states (financial) responsibility."
Rouse said there is one argument that, by providing insurance for the 32 million uninsured, money will be saved.
Currently, if a person does not have insurance, he or she is still treated because of doctors' oath to provide care. Under the new bill, taxpayers will no longer be required to cover the cost. Another theory is that there will be increased competition after the creation of insurance exchanges, or databases listing all available insurance providers.
"From an economic perspective, the ideal situation is perfect competition with lots of different firms with identical goods and the price is lower," she said. "The further you move from that model, the more power firms have to raise prices. The ideal behind exchanges is that it will increase competition and drive premiums down."
Rouse said the expanded coverage to those with preexisting conditions could potentially cause premiums to increase. When those with pre-existing conditions are added, the risk pool will go up.
"The whole idea behind insurance through a company is a large group of where everyone is paying and the (majority) of people are healthy," she said. "With higher risk people, the risk goes up and, even if a fair premium, it will go up. The question is whether the increased competition will outweigh increased costs. It's theoretical."
Foreseeing the future
Though there is no potential for the outright overturning of legislation in Congress, Morgan said the constitutional challenges from the states are more interesting and could be determined by district courts, which are impacted by the politics of judicial appointment.
"There are very sophisticated legal arguments that people can't be ordered to buy health insurance, but there is no way to predict how courts will behave," she said. "The standard up to now is that federal law has supremacy over state law."
While students can easily search for their new health benefits through the bill, Morgan said the information cost often limits the reach of accurate information.
"Your time to get out there and look for benefits and to think about how that really, honestly changes your life, really changes it, that takes time and trouble," she said. "Information is expensive and it costs you something"