How Yale students are informing the public about Obamacare

On a Tuesday morning in March two first–year students at the School of Medicine, Eamon Duffy and Julie Berk–Krauss, faced a class in social work on the campus of Southern Connecticut State University in New Haven. The two medical students were explaining the Affordable Care Act (ACA) to about 20 undergraduates and urging them to sign up—the deadline was a week away. Young adults like those students are important to the success of what is known as Obamacare. Like any insurance plan, it relies on spreading the risk through a pool of healthy people.

The students in this class fall into a category known as “invincibles,” many of whom don’t understand the value of health insurance or have been unable to afford it. Duffy and Berk–Krauss, co–executive directors of Students for a Better Healthcare System (SBHS), were there to discuss the importance and accessibility of health care coverage under the ACA.

The lights dimmed and the pair launched into a 20–minute slide show that discusses one of the ironies of the U.S. health care system—Americans spend twice as much of their GDP on health care as Germany and Japan, for example, yet those countries have much better health outcomes. Other takeaways from the presentation: Health care subsidies are available to those earning up to 400 percent of poverty level and Medicaid access has expanded in those states that offer it. And the government–run health care exchanges foster competition among insurers, making it easier for the 70 million previously uninsured and underinsured to shop for coverage.

As she explained how the ACA will work, Berk–Krauss went for the wallet. Without coverage, she told the students, such unexpected problems as a broken collarbone could cost as much as $15,000. An appendectomy could cost $33,000. “It will be impossible for you to pay your medical costs without insurance,” she said. And, she added, driving the point home, medical bills cause six out of 10 bankruptcies.

The presentation helped at least one student, who said that a preexisting condition meant a $1,200 deductible on her policy. “You really should go online and see if there’s a better quote for you,” Duffy said.

Getting the young to sign up for the Affordable Care Act is just one of the goals of SBHS. Founded in 2013 by Yale medical students, the group aims to inform the public about all aspects of the reform law and to connect community members with assisters who are trained to guide people through the process.

The organization was born out of frustration, said Matthew Meizlish, a second–year medical student and one of four founders. During a first year class in professional responsibility the students lamented that a public debate on the ACA had degenerated into an ideological food fight. Missing was any explanation of the actual changes—the biggest in American healthcare for 50 years‒and how they would affect tens of millions of people. “Instead it was all about misinformation, all about fear. People didn’t have the information they needed,” Meizlish said.

In response, Meizlish and classmates Priscilla Wang, Ankit Kansal, and Lorenzo Sewanan created SBHS. “We wanted to start a conversation that would lead to a more informed national debate,” Meizlish said. “That remains at the core of what drives us.”

Their main tool is the 20–minute presentation the students gave at Southern. Because of their desire to make the complex law clear and accessible, it took the students an entire summer and 15 drafts to hone their first presentation last fall at Gateway Community College in New Haven, Meizlish said.

A year after its founding, the organization is thriving. About 40 students, mostly from the medical school, but also from the schools of law, nursing, public health, and management, as well as Yale College, are involved in educating audiences in New Haven and neighboring communities. As of late March, the group had given about 30 talks to approximately 550 to 600 people, everywhere from churches to clinics, Berk–Krauss said. They have also developed and begun delivering a new presentation tailored to health care providers, to help them act as informed advocates for their patients.

Now, the group is looking to expand. Students at the University of Connecticut medical school have signed on and are informing audiences in the Hartford area, Duffy said. In March, SBHS members received a warm reception when they made a presentation and conducted trainings at the American Medical Student Association convention in New Orleans. They are beginning to work with student groups in states from South Carolina to Arizona. The group’s goal: Students at every American medical school and at undergraduate colleges joining the educational campaign, especially in states like Florida, Texas, and Alabama, where state governments have resisted the law, Duffy said.

“We are hoping to empower students to change the national dialogue around health care reform,” he said. “SBHS is trying to clear the air of all the misinformation and allow individuals to make well-informed decisions for themselves and their families.”

Although the initial enrollment deadline of March 31 has passed, SBHS isn’t going away. The group will keep giving presentations so those who lose coverage between enrollments can use the law and gear up for the next open enrollment that starts in November, Duffy said. The students are also developing a new presentation on what it means to have health insurance, with a focus on patient rights and benefits, and how community members can use their health insurance effectively.

Editor’s Note: President Obama announced on April 17 that about 8 million people had signed up for health insurance through exchanges launched by the Affordable Care Act. That exceeds Obama’s goal of having 7 million people sign up by the end of the open enrollment period on March 31. According to the White House, 28 percent of those who signed up on the federal exchange are between the ages of 18 and 34.