Chad Henderson, director of health services at the University of Rhode Island and former ACHA president, said Rhode Island chose to mandate health insurance for students decades ago because paying for health care for the uninsured was having such an economic impact on local hospitals. Retention also was a factor, he said.
"If students stay well, they persist better, they do better academically and, hopefully, they graduate in a reasonable amount of time," Henderson said.
But some schools are not so sure. Joyce Roosz, the business office and student insurance supervisor at Purdue University, said a mandate has not been discussed seriously among the higher ups at Purdue, but it is something the department that runs the optional insurance plan has talked about before in meetings.
"At this point in time, I don't think we're going toward that policy right now," Roosz said. "I just don't think that this is the economic climate where we want to push mandatory health insurance. Students are sometimes just having difficulty getting money for tuition. Even though we think it's very important and encourage students to have coverage through their parents or to get a catastrophic plan, I just don't think this is the time to pursue it."
Many universities, especially private ones, have had health insurance mandates for years.
And many of the major public university systems in the U.S., including the University of California system, the University of Minnesota and the University of Montana, require students not covered through a parent or private plan to purchase university-sponsored coverage.
Most mandates have come from the bottom up, after major state universities choose on their own to require insurance. Massachusetts was the first state to mandate coverage via a state legislature for full- and part-time students in 1989.
About 50 percent of undergraduate students and about 80 percent of graduate students are covered under the University of California at Berkeley plan, which offers medical, dental and vision coverage.
Berkeley mandated coverage in 1990 after students voted for a referendum requiring health coverage as a condition for enrollment.
"It was the students saying, 'We want health insurance. We want adequate coverage so that were not suffering under large medical bills,'" said Heather Pineda, director of the student health insurance plan.
A decade later, the University of California system board of regents passed a regulation requiring coverage for undergraduates at all the system schools. They are expected to pass a similar regulation for graduate students in November, Pineda said.
"The mission of the university is to educate students and anything the university can provide to the students to help them accomplish that goal is a benefit to the university," she said.