A Guide to Birth Control Coverage for Students of Religious Universities Under Trump Administration’s Proposed Regulation

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If you are currently enrolled, or plan to enroll, in a student health insurance plan through a religiously affiliated university, changes proposed this week by the Trump Administration may affect your coverage.

What happened?

On this past Monday, May 23rd, the Trump administration drafted a regulation seeking to repeal the birth control mandate included in the previous administration’s Affordable Care Act (ACA). The proposed changes would effectively allow any employer to remove birth control coverage from its health care plans on religious or moral grounds. Under the rule, a university may be considered an “employer,” meaning that if it goes into effect, student health care plans may see contraception removed as a covered benefit.

Where did this come from?

Health care coverage for contraception has been an ongoing debate, especially in recent years under the Obama administration. Here are the key political changes that led us to the current state of birth control coverage:

  • In 2010, the Obama administration passed the Patient Protection and Affordable Care Act (Affordable Care Act, ACA, or Obamacare). Among other provisions, the ACA requires health care plans to cover birth control in addition to seven other “women’s preventative health benefits.”
  • As a response to the birth control mandate, a number of religious institutions – including hospitals and universities – began to push back politically. Initially, the only employers exempt from the birth control mandate were places of worship. Some religiously-affiliated hospitals and universities were also granted an exceptional status.
  • In 2014, the Supreme Court decided Burwell v. Hobby Lobby, which expanded the permitted exceptions to the birth control mandate to include “closely held” private businesses with opposing religious or moral convictions.
  • The regulation proposed this week seeks to repeal the Obama administration’s birth control mandate entirely, allowing any employer to deny birth control coverage in its health care plans, regardless of the type, size, or nature of the institution.

What could happen to my coverage?

At Georgetown, approximately 20% of all undergraduate students and approximately 30% of all graduate students are enrolled on the student health insurance plan and could have their care affected.  The Trump administration’s proposed changes would be removing the existing restrictions on the denial of birth control coverage, including for universities’ student health care plans. Because Georgetown is a religiously-affiliated institution, it is possible that forms of contraception currently covered by student health insurance could cease to be included.  

If a change is put in into effect before the beginning of the new coverage year, Georgetown will be required under the law to notify student plan-holders of any changes to their health care coverage, and to make clear in related documents that contraception is not a covered benefit. However, if birth control coverage is removed at the beginning of the coverage year, plan holders will likely not be notified; rather, the details will be written into the plan without an explicit notice of the change.

At a GUSA Roundtable on March 22, 2017, Vice President for Student Affairs Todd Olson assured attendees that students would have some role in the deciding the future of the policy in the event of an appeal, but indicated that the ultimate decision would reside in the highest levels of the University’s administration.  H*yas for Choice continues to monitor the situation both on campus and nationally, and we will not let any rollback in coverage go unopposed.

What can I do?

In order to give Georgetown the message that students rely on their health insurance for birth control coverage, H*yas for Choice is collecting data. If you have used or plan to use student health insurance for birth control, please help us present this information by filling out our short, five-minute survey.

H*yas for Choice remains committed to following this issue and providing accurate, timely updates to students on their coverage and any changes that occur. If you would like more information on this issue, you can read about it here or get in contact with H*yas for Choice through our Facebook page, website, or email (hfchoiceboard@gmail.com).  

 

 

This Week in Trumpcare

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A quick, informative breakdown on the proposed changes to federal healthcare policy from the H*yas for Choice Board

What happened?

For the past several weeks, Senate majority leader Mitch McConnell has been drafting a health care bill completely behind closed doors. The Better Care Reconciliation Act of 2017, meant to replace the Obama administration’s Affordable Care Act (ACA), is an amended version of the bill put forth in May by the House of Representatives, the American Health Care Act (AHCA). In addition to leaving a projected 54 million Americans without insurance over the next decade, the Senate’s bill will provide billions of dollars in tax breaks to the wealthy and attempt to offset this loss in revenue by cutting health care benefits from women, low-income people, people of color, elderly people and people with disabilities and chronic illnesses. On Thursday, the text of McConnell’s secret bill was finally released, simultaneously to Congress and to the public.


What changes were included from AHCA to BCRA?

Like its House counterpart, the Better Care Reconciliation Act attempts to cut taxes on the country’s highest earners, those with annual incomes of $250,000 or more. In comparison with the previous version of the bill, however, the Senate’s proposed plan contains more drastic cuts to Medicaid over a longer period of time. At the time of the AHCA’s proposal, the Congressional Budget Office estimated that some 23 million Americans would lose their healthcare coverage under the House’s bill; current projections are even higher. And unlike the House bill, the Better Care Reconciliation Act repeals the ACA’s individual mandate while making no attempt to replace it.


What are the key differences between Obamacare and the new plan?

House and Senate Republicans alike are working to, overall, cut healthcare spending – particularly to Medicaid, which allows low income people to access a variety of healthcare services at a reduced cost or with no cost at all. The ACA brought with it a number of taxes that helps the federal government to pay for these services; the new bill will seek to repeal most if not all of these taxes, including those on millionaires and billionaires. In short terms, the bill being considered by Congress repeals:

  • Taxes on drug companies, tanning salons, health insurers, medical device manufacturers, investment income, and incomes over $250,000. While no longer requiring these taxes on the wealthy, the new bill will take away tax credits that under Obamacare helped middle-class families pay for out-of-pocket medical expenses.
  • The individual mandate, requiring and incentivizing people to be and stay insured. The AHCA replaced the mandate by charging anyone who goes 63 days without insurance a 30 cent surcharge on their premiums for a year. The bill released on Thursday, however, repeals the mandate and replaces it with nothing.
  • The employer mandate that ensures penalties for any company with more than fifty employees that fails to provide them with health insurance.
  • The mandate requiring insurers to cover essential health benefits, including mental health counseling and women’s sexual and reproductive health services. The new bill will allow states to waive these requirements.
  • Medicaid expansion. The new plan, instead of expanding the program, will cut $880 billion.
  • Protection against additional costs or the denial of care for plan-holders with pre-existing conditions. The new healthcare plan will allow states to waive this mandate, allowing employers to charge extra for plan-holders with conditions such as alcohol dependency, high blood pressure, eating disorders, acne, asthma, anxiety, “transexualism,” and pregnancy.

Who is affected by these changes?

The bill before Congress takes away care from millions of Americans from a variety of backgrounds and groups; this being said, the hardest hit by these changes will undoubtedly be people from marginalized groups, including low-income people, people of color, people living in rural areas, people with disabilities and chronic illnesses, women, and people with reproductive health needs. These are the ways in which people can lose coverage based solely on who they are:

  • People who qualified for Medicaid under Obamacare. The new healthcare plan will end the ACA’s Medicaid expansion by 2021, meaning that people who previously did not qualify for its benefits will lose them again.
  • People who qualified for Medicaid before Obamacare. Currently under the ACA, the federal government matches or nearly matches state spending on Medicaid. The new plan will instead impose a “per capita cap” on federal Medicaid spending, which would amount to hundreds of billions of dollars taken away from recipients in just ten years.
  • People with disabilities who use in-home care. Medicaid mandates institutional care for people with disabilities while community-based support is only provided based on the availability of state and federal funds. This means that cuts to Medicaid will directly cut funding for in-home services. For disability rights activists and people with disabilities, this is not an issue of preference; it is an attack on their autonomy and civil rights.
  • Low-income people who don’t qualify for Medicaid. The ACA ensured tax credits covering 70% of medical expenses; today’s bill brings that number down to 58%, raising the cost of deductibles and copays.
  • Anyone who utilizes Planned Parenthood’s services. The Republican bill would end federal reimbursements for Planned Parenthood’s services, meaning that Medicaid and Title X recipients would be forced to pay for contraception, STI testing, pap smears, and cancer screenings out of pocket. Over 60% of Planned Parenthood’s patients access its services through these publicly funded programs. More than half of Planned Parenthood’s clinics are in rural and/or medically underserved areas, and nearly half of its patients are women of color.

 

What does “defunding” Planned Parenthood mean?

Planned Parenthood clinics across the country receive Medicaid and Title X reimbursements, which allows medical professionals to serve, consult and treat patients with reproductive health needs and limited financial means. A vote to “defund” Planned Parenthood would end these reimbursements, meaning that patients who rely on federal programs to access their sexual and reproductive healthcare would have their care taken away. This change is directed almost entirely at low-income people, and disproportionally at Black and Latina women, who are significantly more likely to be diagnosed with and die from cervical cancer. Planned Parenthood presently receives reimbursements for the provision of birth control methods, STI testing, cancer screenings, pap smears, and breast exams, all of which Medicaid and Title X recipients would resultantly be expected to pay for out of pocket.

Although anti-choice legislators such as Speaker Ryan claim that their motivation for “defunding” Planned Parenthood is to keep taxpayer money from paying for abortions, the reality is that Medicaid has already been blocked from funding abortion services by the Hyde Amendment since 1976. Therefore, the only services affected by the ban will be those listed above; abortion care, at the federal level, was already “defunded” four decades ago.


What can I do?

As Congress continues to deliberate its healthcare bill, legislators are listening to their constituents. When you make a quick phone call to your senators’ offices, the staff member with whom you speak will make note of your opposition to the passage of the bill and relay this information to your legislator. Don’t know quite what to say? Planned Parenthood Action Fund provides a guide on how to call and produced this script.

H*yas for Choice remains committed to monitoring changes to this issue and providing you with accurate, timely updates. As always, HFC will continue to resist this dangerous, oppressive bill and keep you informed as to what’s going on and what we, as a community, can do about it.

“Just Two Teeny, Tiny Pills”: The Power of Medication Abortion

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by Talia Parker.

Talia Parker ’20 is a member of H*yas for Choice’s leadership team.


Let’s talk about medication abortion. It’s just two teeny, tiny pills, but the agency these pills grant is monumental, and every single person around the world should have access to this power if they need it.

Despite manufactured perceptions of abortion as an extremely invasive and traumatic procedure, medication abortion – which currently accounts for about 20 percent of US abortions – is a safe and straightforward process. A medication abortion consists of two pills: mifepristone and misoprostol. In the United States, a person seeking a medication abortion is administered the first pill, mifepristone, in an abortion clinic such as Planned Parenthood or a private doctor’s office. Mifepristone blocks the release of progesterone in the body, which effectively prevents the pregnancy from progressing. Then, 24-48 hours later, the second pill, misoprostol, is taken at home or any comfortable and safe location. Misoprostol empties the uterus, which causes cramping and bleeding for about 5 hours. Medical professionals are on call 24/7 if there are any concerns or complications during the expelling phase of the abortion, but for most people the process is smooth and similar to a heavy period. Medication abortion is an extremely safe medical procedure – only 1 in 100,000 people will die from a medication abortion. Compare that to the fact that in the U.S. approximately 14 in 100,000 people die in childbirth, and that number goes into the two-hundreds when averaged worldwide.

Medication abortions were first approved in the United States in 2000. However, regulations have recently changed – expanded access to the abortion pill in the US means the pill can be administered at up to 10 weeks instead of 9 and the dosage of misoprostol has been reduced by two thirds. These two specifications have made medication abortions much more accessible in the U.S. by decreasing costs for the procedure and increasing the number of people who can use it.

Needless to say, abortion access in the U.S. is constantly threatened by federal and state Republican legislators. However, there are many other countries in the world where abortion is either entirely illegal or severely restricted, and in these countries the abortion pills have created the possibility for a safe underground abortion network.  

The international organization Women on Web sends the two abortion pills to people globally so that they can have abortions on their own. Only serving countries where abortion is extremely restricted or illegal, Women on Web conducts online medical consultations with those seeking abortions and if the procedure is approved, send the medication through the mail. Volunteers at the organization remain in constant digital contact with the patients during their medication abortion for support and to make sure everything is going well. If a patient were to experience a medical complication for any reason, they can go to an emergency room and say they had a miscarriage. The abortion pills mirror the biological process of a miscarriage, so there would be no way for the doctor to be able to tell if the patient is lying, and therefore the patient will not face backlash for the abortion laws in that country.

Wondering how this is legal? People are allowed to receive medication through the mail as long as it is only for personal use. Also, both mifepristone and misoprostol are on the World Health Organization’s list of essential medicines, and because they are not narcotics or controlled substances, no violation of customs regulations occur.

People around the world deserve the right to make their own choices about their own bodies. Abortion pills are a safe way to give people control over their lives, regardless of what country they live in. It is imperative that we continue our fight for safe, legal, and accessible abortions here in the U.S., lest we be added to the list of nations where people are forced to seek abortion through other means.

If you’re interested in making a donation to Women on Web: https://www.womenonweb.org/en/donate

 

Some sources:

https://www.womenonweb.org/en/page/1117/in-collection/6901/is-it-legal

https://www.plannedparenthood.org/learn/abortion/the-abortion-pill

http://data.worldbank.org/indicator/SH.STA.MMRT?name_desc=true

https://www.nytimes.com/2016/03/31/health/abortion-pill-mifeprex-ru-486-fda.html

https://www.womenonweb.org/en/page/523/questions-and-answers-overview

http://worldabortionlaws.com/map/

Georgetown, You’re Better than Gender Ratios

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If you attend Georgetown, and you enjoy spending your Saturday evenings downing six shots of Cherry Burnetts and half a Natty Lite whilst surrounded by your favorite Jesulittys, then chances are you have encountered bouncers at parties. These figures — almost universally male — determine who gets to enter the humid Henle, and, when it comes to deciding which pack of dizzy first years they allow to enter their domicile, make their judgments based almost entirely on gender. If you pass as male, you know the urgency with which you gather female students outside of parties, hoping to pad your own masculinity with their feminine wiles. If you pass as female, you know how it feels to be begged by Sperry-wearing men to accompany them to the party. You also know how it feels when the bouncer too easily opens the door after a brief glance at your beat face.

Although gender ratios ostensibly benefit women —  perhaps what Reddit-dwelling men’s rights activists might even term “female privilege” — in reality,  the logic behind them reflects patriarchal conceptions of women as sex objects. I will admit — it feels glamorous to glide into an exclusive party with no objection from the host, as a protesting line of men don’t make the cut. Meanwhile, I can imagine that for those who are denied entrance to such functions, it is easy to feel that in this situation, it is women who benefit.

Before feeling empowered or embittered by gender ratios, however, consider the logic justifying them. The appeal of women at these parties derives exclusively from their sex appeal; men hosting parties want women at parties because they want to hook up with them. Therefore, gender ratios privilege the heterosexual male experience by prioritizing their desires. The preferencing of heterosexual cis male needs is a key element to the maintenance of the patriarchy.

Additionally, gender ratios reduce women to society’s perception of their  sexual value. With gender ratios, women are collected, their individuality is disregarded, and the objective of toxic masculinity — to capture women in order to have sex with them — is universalized.

Gender ratios are pervasive at Georgetown; in fact, they are so pervasive that I recently attended a party celebrating the victory of our newly elected GUSA President and Vice-President, Kamar Mack and Jessica Andino, that enforced a gender ratio at the door.

I do not know the details of how their party was organized; for all I know, Mack and Andino were entirely unaware that a bouncer was only admitting girls at the door of the party. I will also clarify that the party was not hosted at Mack or Andino’s own residence, and I did hear discussion inside the party that the bouncer was acting waywardly.

An objective fact remains, however: gender ratios at parties are so ubiquitous at Georgetown, even a party for the executives of the student body government enforces them.

In order to transform this issue, we need to address systemic issues, primarily the way that the patriarchy encourages heterosexual men to view their sexual exploits as conquests, a logic that disregards consent and pleasure, the two most important aspects of sex. On Georgetown’s campus, we need to foster an open dialogue to unpack why we accept and expect gender ratios. Hopefully, then we can create an environment where we can turn up without turning women into currency to be exchanged.

Rachel Biggio (COL ’20) is a member of H*yas for Choice’s leadership team.

Zika, Fear, and Recycling Oppression

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As Spring Break approaches, many of us are heading off on tropical vacations. Unfortunately, many of these destinations attract mosquitoes as well as college students.  Although mosquitoes are not in Cancun for the tequila, they continue to thrive and transmit the Zika virus.  Like many public health emergencies, the Zika outbreak has faded from the headlines.  As students travel to Zika hot zones and as warm weather returns, Zika remains a substantial concern.  

On November 28th, Texas state health officials announced a probable case of local transmission of the Zika virus.  Later that week, Texas finalized a rule requiring facilities that provide abortions to pay for the cremation or burial of fetal remains.  Although these events may not seem interconnected, the narrative of the Zika outbreak centers on reproductive health access, specifically abortion.  Because Zika virus can cause birth defects, including microcephaly, abortion rights activists seized Zika as an opportunity to advocate for removing barriers to abortion, in Texas, and around the world.  The proximity of the most recent Zika outbreak poses an increased risk to the United States and, as a result, secured significant media attention.  Due in part to the strict abortion policies of many Latin American countries, like Brazil, the media and abortion rights activists quickly turned to the potential of the Zika outbreak to liberalize abortion policy.  

Historically, within the United States, German measles outbreaks in the 1960s and early 1970s shifted perceptions of abortion.  Like Zika virus, German measles can cause severe birth defects.  Outbreaks of German measles in pre-Roe America expanded access to abortion beyond cases where the life of the mother was at risk, to cases where the fetus was assumed to have severe developmental defects.  Although outbreaks of German measles led to the expansion of abortion access, and arguably heralded eventual legalization of abortion nationally,  this expanded access to bodily autonomy came at the expense of the disabled community.   American experiences with German measles established an ideology that no parent would want a child with a disability, an assumption that demonstrates a lack of respect for people with disabilities.   

Because advocacy emphasizing children with disabilities successfully expanded abortion access in the United States, it is not surprising that modern pro-choice advocates are using similar tactics to expand abortion access in many Latin American countries.  At issue are both the right of a person to exercise their autonomy and the struggle people with disabilities face justifying their existence.  Reproductive rights advocates in the United States and globally have seized upon the fear of Zika to attempt to confront barriers to abortion access like the new fetal remains rule in Texas.  The depiction and rhetoric of the prenatal effects of Zika employed by pro-choice advocates potentially undermines the lives of people with microcephaly.  Many people could benefit from learning about the realities of raising a child with disabilities.  However, state laws that compel providers to present inaccurate medical information, enforce mandatory waiting periods, and dictate the means of disposal of fetal remains threaten the provider’s autonomy and the autonomy of pregnant persons.  In the context of current state-based abortion policy, the possibility of educating potential parents is burdened with the legacy of reproductive oppression.                     

Still, the reproductive rights community has neglected to address how advocacy for less restrictive abortion policies on the basis of fetal abnormality in areas with local transmission of Zika diminishes the value of the lives of people with microcephaly and other disabilities.  When a provider diagnoses a fetus with microcephaly, a parent who chooses not to terminate their pregnancy may be stigmatized and the child may lack sufficient resources to thrive.  Too often in abortion debates, especially in the United States, the only ethical consideration is whether a fetus has autonomy and, if a fetus has autonomy, at what point that autonomy begins to exist.  Within the framework of Zika, reproductive rights advocates, like myself, are challenged to consider the broader effects of our arguments and actions.  While a person’s reasons for accessing an abortion should not be questioned, the fear-mongering of abortion rights groups as a tactic to increase access to reproductive health care risks oppressing another group of people.  Since people seeking abortions face somewhat similar oppressions in gaining control of their bodies as people with disabilities, reproductive justice activists should understand that utilizing oppressive arguments to gain greater personal autonomy will not create an environment where the autonomy of every person is respected.


Brinna Ludwig (NHS ’17) is a co-president of H*yas for Choice.

H*yas for Choice Grades the 2017 GUSA Candidates

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This election cycle, as always, the H*yas for Choice executive board sent all candidates who launched their campaign at the beginning of the election cycle a questionnaire detailing our policy goals for the next academic year and beyond. Below are our final grades for the candidates. Attached at the bottom of this post is a detailed guide to our grading.

Garet and Habon – A-

H*yas for Choice was impressed by Garet and Habon’s initial platform and responses to our more specific questions.  We were particularly enthused by their demonstrated understanding of issues at the Student Health Center and support of university funding for free and anonymous STI screening.  Additionally, their research on the implications of ACA repeal and commitment to pressuring Georgetown University to maintaining current health care standards was evident in their platform and in their response to our questions.
Our primary concerns, although few, are with their lack of public support for free menstrual hygiene products.  Unlike other candidates, who pursued informational meetings, we did not have the opportunity to meet with Garet and Habon to share our institutional knowledge, giving us some concern about our continued working relationship with GUSA. Therefore, we give Garet and Habon a grade of A-.

 

Kamar and Jessica –  B+

H*yas for Choice was impressed with Kamar and Jessica’s willingness to learn about ongoing issues for students at the Student Health Center, roadblocks to the implementation of STI testing, and the limitations unrecognized groups experience. In particular, HFC was enthusiastic about their plan to appoint a two different GUSA members to handle Greek life issues and other unrecognized group issues. Additionally, Kamar and Jessica shared specific, substantial plans to institutionalize access to free menstrual hygiene products on campus.

HFC’s gravest concern with Kamar and Jessica’s campaign is their perceived reticience to aggressively advocate for a continuation of the limited contraception coverage offered by student health insurance and the Student Health Center, should a repeal or alteration of the ACA remove Georgetown’s mandate to cover these services. Additionally, Kamar and Jessica want to focus on external funding for free and anonymous STI testing, rather than pushing for institutionalized university funding. While HFC supports this policy in the short term, we believe GUSA’s unique relationship with the university administration gives them greater leverage to push for university funding. Therefore, we give Kamar and Jessica a grade of B+.

John and Nick – C+

H*yas for Choice was pleased by John and Nick’s unequivocal support for contraception coverage on student health insurance and at the Student Health Center regardless of changes to the Affordable Care Act. Further, HFC is intrigued and cautiously optimistic regarding their newly proposed policy pooling university students’ health insurance together across the country.

However, after meeting with John and Nick, H*yas for Choice still has severe reservations regarding their support for some of HFC’s policy goals. Fundamentally, the Matthews/Matz campaign emphasizes reducing the size of GUSA and cutting university costs. HFC fears this – admittedly admirable – mindset may come at the price of achieving some of our goals that also aim to make Georgetown an affordable option for students, specifically free menstrual hygiene products. Additionally, the adversarial nature of John and Nick’s initial rollout of their student health policies after H*yas for Choice released our grades last week leaves HFC members concerned a proactive, healthy working relationship may not be as easily attained as with other candidates, and we give them a grade of C+.

hfc-candidates-edited

Click here for the responses from Garet and Habon, Kamar and Jessica, and HFC’s grades.

Click here for the responses from John and Nick and HFC’s grades.

 

Three Hours and a Rigamarole at the Student Health Center

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by Brinna Ludwig


Last spring, aftering hearing about some problems students had been having with the Student Health Center H*yas for Choice launched a survey to find out more.  When the responses began coming in, I felt shocked: although some people left the Student Health Center satisfied, many left feeling defeated and disempowered, especially if their visit was related to sexual or reproductive health.  After reading other people’s experiences, I needed to see for myself.  This is my experience getting screened for sexually transmitted infections (STIs) at the Student Health Center, and, as you might have guessed, it was not a pleasant one.  

I scheduled my appointment on Friday, October 21.  I made the appointment in the morning to avoid long wait times, I called my parents to see which lab my insurance company covers, and I even made sure to eat a well-balanced breakfast.  Most sexually active individuals should be screened for STIs at least once a year, or with every new partner.  I had not previously taken the initiative to get screened in part because the Student Health Center does not promote free and anonymous STI screening.  Many other universities promote free and anonymous STI testing, partly because students are such a high risk population.  People between the ages of 15-24 account for half of new STI cases.  The fact the Georgetown fails to provide this basic service is not just discouraging, but negligent.          

I arrived to my appointment a few minutes early to sign in and give the Student Health Center my insurance information.  Because the Student Health Center does not offer free and anonymous testing, I had to pay a $20 copay to see a nurse practitioner.  Since I was displaying no STI symptoms, seeing a any healthcare provider seemed unnecessary.  I knew exactly what I wanted to be screened for: syphilis and HIV with a blood test, and gonorrhea and chlamydia with a urine test.  If the Student Health Center provided free and anonymous STI screening, I could have avoided both the copay and the appointment time.  

Once I actually saw the provider, she asked me a few questions and recommended that I be tested for HIV, syphilis, gonorrhea, and chlamydia.  It was all going according to plan.  I didn’t think to ask my provider about the different labs because I wrongly assumed that she would look and see what my insurance covered.  She handed me the scripts for the tests and told me to wait in line for the Student Health Center lab.  This confused me because the Student Health Center works with Quest and my insurance only covers LabCorp.  At that point I still trusted the system and waited patiently.  Once in the lab, I was going through the basic information with the nurse and requested that my lab work be sent to LabCorp.  She seemed confused, as if no one had ever used LabCorp before.  Fun fact: the main labs the nation’s biggest insurers cover are Quest and LabCorp, so I am in no way in the minority with my insurance coverage.  Finally, after the office was aflutter with confusion, as if I had suddenly asked an intriguing but difficult question like, “is a hot dog a sandwich?”, “when is ‘Y’ a vowel?”, or “are all Sesame Street puppets muppets?”, I was given two new scripts and told to go across the parking lot to the hospital lab.  

I promptly walked across the parking lot and entered the hospital.  After having to ask for directions more times than I care to admit, I found the lab.  I had to go through another intake process and  wait for them to call my name.  Because I was at the hospital lab, there were significantly more patients.  It felt like all of Georgetown Hospital was there.  One man even came in with a green bucket with some kind of biomedical sample, (I spent my time speculating what was in the bucket.  My ideas included: hairball, kidney, and a blood bucket à la It’s Always Sunny in Philadelphia).  I am making light of my experience, but in actuality, I was scared.  Being in a hospital by yourself is scary, and I felt uncomfortable using a hospital lab for STI screening, even though I knew that’s why they were there.  

When my name was finally called, I was informed that one of my scripts was incompatible with LabCorp, which tells me that my provider was not accustomed to writing orders for LabCorp at all.  This meant that I had to return to the Student Health Center to get the proper script and then resubmit the form at the hospital lab.  Luckily, they were able to take the samples without the script, so I did not have to wait in the hospital lab again.  Unfortunately, the Student Health Center does not seem to share the same views on customer service.  I had to wait another half an hour at the Student Health Center to get the script and my provider did not even apologize for the situation.  At long last, I was able return to the hospital lab and hand them the script.  Finally, the saga was over.  

The whole process took over three hours.  I do not write this to complain.  I write this because it points to a larger issue within the Student Health Center.  I worry about other students, who may not be aware of which lab their insurance covers and may unnecessarily pay for services that are covered by their insurance.

Leaving the hospital lab that day, I felt disempowered.  By getting screened for STIs, I was supposed to be exercising agency by exerting control over my sexual health.  The whole process left me exhausted.  I, a senior in college, a healthcare management and policy major with extensive knowledge of the healthcare system, and co-president of H*yas for Choice, struggled to navigate the system.  But alas, that was not the end of my story.  

After waiting more than three weeks for my results, I called the Student Health Center.  Soon, my provider called me and told me they couldn’t find my results and that I could come in again to get tested.  Obviously, that was the last thing I wanted to do given the odyssey I had endured almost a month before.  When I finally got the call that my tests were normal, almost a month had passed.  From my rigmarole, I learned a few things about the Student Health Center:

 

  1. If the Student Health Center offered free and anonymous STI screening, I wouldn’t have had to go through any of this
  2. At that point in October, the Student Health Center seemed completely unable to deal with LabCorp, despite the large subsection of the student population whose private health insurance requires its use
  3. Students did not seem to be top priority at the Student Health Center

 

It’s taken me a long time to write about my experience because it was so unpleasant.  I didn’t want to revisit the feelings of confusion at the Student Health Center, my fear at the hospital lab, or my aggravation at trying to get my results.  Ultimately, I don’t think my experience is all that unique.  I know there are students sent to the wrong lab and billed for their tests.  I know there are students who never follow up about their test results.  And I know that people are often misbilled.  That’s why H*yas for Choice launched our Student Health Health Center survey.  We want to hear it all because we want to know the problems and find ways to solve them.    


Brinna Ludwig (NHS ’17) is a co-president of H*yas for Choice.