Note: The Reveille is dedicating an investigative series to the operations of the Student Health Center. This is the second part of an ongoing series.

When LSU international graduate student Soheil Kafili set up a meeting with Julie Hupperich, executive director of the Student Health Center, to discuss solutions for students who can’t afford medical services on campus, he said he didn’t get any answers. 

Two hours into the Zoom meeting, which The Reveille obtained a recording of, Kafili said he and the other students made no progress in finding short-term solutions for their situation. 

“The short-term plan is to enroll in better insurance coverage,” Hupperich said to the students during the meeting. “Or connect with our case manager who can help you to connect with other resources.”

“You’re not offering anything,” Kafili said in response to Hupperich. “I’m asking since you’re not offering anything, and [the] LSU insurance plan is very expensive for everyone, and no one wants to use that.”

Kafili went on to recommend solutions like re-prioritizing funding within the Student Health Center to reallocate money to lower the cost of primary medical services for students. 

Hupperich said that students need to enroll in health care coverage and that students can meet with the case manager today. 

Kafili said that Hupperich is putting the problem on students in response to her restatement of her short-term solution.

The conversation was “going in circles,” Hupperich said, and that the Student Health Center has not received many complaints about billing. She has tried to advocate for students who can’t afford the university’s plan, she said.

When LSU partnered with the LSU Healthcare Network on May 10, 2021, it became “in-network” with most major US-based insurance plans, so that more insurances could be used at the Student Health Center. However, students believe this also caused a raise in primary care prices. 

“We try to put safeguards in place so that students wouldn’t just wave out of appropriate coverage and get these substandard plans, and for the students who have done that, it’s had a major impact, and we see it every day.” Hupperich said. “It’s hard for us to see because they don’t have the access they need. But we did everything that we could to advocate and support them and educate them in the process, so they wouldn’t end up in this place.”

But they still did end up in that place, Kafili said. He said the Student Health Center is just trying to get revenue out of students.

International geophysics graduate student Ritu Ghose is from Bangladesh and is president of the International Student Association at LSU. She was one of the three international students in the meeting with Hupperich.

“I don’t know if she was even considering the fact that international students cannot afford the LSU health insurance,” Ghose said.

The cost for the LSU sponsored health insurance plan (SHIP) is $3,064 annually, according to LSU’s billing and insurance website. Students enrolled in SHIP also have to pay ranging copayments on top of the $3,064 cost. The additional $185 student health fee from the university’s fee bill is another payment SHIP-enrolled students are responsible for as well as all full-time students.

Because many students can’t afford to enroll in SHIP, they enroll in cheaper insurances that may not cover as much of a service as they would hope. Many international students enroll in International Student Insurance, known as the ISO plan.

“We encourage students to enroll in the university-sponsored plan because anybody with an ISO plan is grossly under-insured, and no matter where they go, even if it’s in-network with their plan, that plan covers next to nothing,” Hupperich told the students during the meeting.

The problems started a year ago when the Student Health Center became in-network with other insurance plans and changed certain financial policies, such as the cost for certain services, Ghose said. Students with good health insurance have the option to receive medical care from anywhere.

“At the time, we knew [LSU going in-network] would disproportionately impact international students and graduate students,” Hupperich said. “We actually requested that the leadership consider mandatory insurance.”

Hupperich also wanted a hard waiver so that international students would have to either enroll in SHIP or provide proof of an equally robust plan, so they wouldn’t be able to enroll in insurance that provides little-to-no coverage, she said. Her efforts of enforcing mandatory insurance and a hard waiver did not succeed.

“You’re cutting off the benefits that would previously help the students with no insurance or students who are underinsured, so you’re not thinking about students,” Ghose said. “[You’re] thinking about business here.”

Ghose feels terrible that the SHC has put her and her colleagues in a financially stressful situation. It is especially not fair to international students, she said.

“When [international students] come here, they don’t have any idea about the whole situation,” Ghose said. “In their I20s, it’s not written that ‘hey, the medical care situation is kind of like that there.’ They don’t have any idea about that.”

Director of Revenue Cycle Compliance at ACS Medical Billing Solutions, the billing company for the Student Health Center, Rachel Ricks, responded to billing criticisms regarding late fees in a past article by The Reveille. She said that ACS does not charge late fees and does not set any prices.

Instead, insurance companies set the prices of visits to the clinic, Ricks said, and if ACS did charge a late fee, that would be a violation of contract.

“That [charging late fees] would be a violation of contract,” Ricks said. “Pretty strict government and state laws for some patients, and there are other rules and guidelines that govern what we can send the statement to a patient for.”

Chief Operating Officer of ACS, Peggy Kelly, said that ACS is open to questions at any time and generally has no problem communicating with students about issues that come up.

“We have attempted and have always made that our forefront is to help these students walk them through whatever we have to walk them through as best we can, and I do think that the clinic is trying to make that something a little bit more proactive, if you will,” Kelly said.

Two students may receive the same service at the clinic, but due to differing insurances, one student may be responsible for a deductible or a higher out-of-pocket cost, Kelly said.

All international students must sign a waiver before changing insurance, Hupperich said.

“They go through a process where they have to answer certain questions about the new plan that they intend to enroll in, and it walks them through questions that make sure that they basically are getting comparable coverage to the university-sponsored plan,” Hupperich said.

The SHC crafted the questions to protect the student, Hupperich said, so that students are educated during a walk-through of what to look for in a health plan. The challenge comes into play when a student completes the waiver but still enrolls in a plan with little-to-no coverage, she said.

According to Kafili and Ghose, international students are still not satisfied with Hupperich’s response, and they plan to conduct a town hall with Hupperich so that more students can voice their concerns. 

“If we can afford a robust insurance, what’s the need of a Student Health Center on campus?” Ghose said.