Opinion guest column

A $6,000 bill and inadequate coverage: How MIT health insurance fails graduate workers

To win comprehensive healthcare coverage, MIT graduate workers must come together to form a union

All MIT graduate workers know that the cost of living in the Boston/Cambridge area is exorbitant. Now, imagine being hit with a surprise $6,000 medical bill — this is the nightmarish reality for some graduate workers at MIT. 

Despite MIT’s extreme wealth, many of its graduate workers with chronic health needs do not receive affordable care with the currently-offered student insurance; moreover, relief funds meant to help with unexpected medical costs are poorly publicized and can be denied on arbitrary technicalities to the graduate workers who need them most. To secure comprehensive healthcare coverage and to make sure that every graduate worker can afford to receive the healthcare they need, we must come together to form a union. 

Most graduate workers are covered by MIT’s Student Extended Insurance — our only option for affordable healthcare. Unfortunately, as Alex, a graduate worker in the Biology department discovered, one critical category of care inadequately covered by MIT is meal support and nutritional counseling — the standard of care for eating disorders. Over the last year, Alex was hospitalized repeatedly and required daily nutritional support in order for her to be able to perform her research and work towards her degree. She was required to pay a $25 copay per daily session; while $25 may seem small, this fee added up to over $2,000 over three months. 

After accruing this $2,000 debt, Alex could no longer afford her copays and was forced to stop some of her recommended treatment early. At the same time, she was still suffering from severe mental health symptoms and — having exhausted traditional lines of pharmaceutical care over the preceding several years — was prescribed a new drug to treat PTSD symptoms and severe, treatment-resistant depression. The worker received pre-authorization for the treatment, but despite this, MIT insurance did not completely cover the cost of the drug, leaving her with an additional $4,000 bill on top of the $2,000 debt that she had already incurred. 

What graduate worker can cover a surprise bill for nearly $6,000?

MIT ostensibly offers financial assistance for unexpected medical expenses via the Miller Fund, but has declined to cover the cost of Alex’s new drug and the accrued copays on an outrageous technicality. Because the worker had to charge most of the costs of the treatment to a credit card (Alex was never informed that this could be disqualifying, but had no other option to afford her necessary healthcare), the expenses were considered “already paid.” Therefore, Alex was ineligible, even though she had no means to pay down the resulting credit card bill other than by seeking personal loans from her friends. 

Accessing the Miller Fund is made even more difficult and confusing by the requirement that applicants must have a sponsor for their claim. When the worker’s psychiatrist left MIT for a new position, she was told to find a new sponsor and file a new application in order to continue making the case that she should receive financial relief. As of today, the Miller Fund still has not covered any part of the $4,000 bill (and no part of her previously-accrued $2,000 debt).

In September, the MIT healthcare plan unexpectedly changed without notification, withdrawing a previous expansion of coverage: the MIT administration claims to have had no warning that this change was coming. Unbeknownst to graduate workers and other beneficiaries, coverage for any support provided by a registered dietitian was reduced to 12 sessions per year with a $25 copay, after which any additional sessions would not be covered at all. Because Alex needed to see a dietitian so frequently, by the time she found out about these changes, she had incurred an additional $3,000 in charges. Initially, MIT refused to investigate whether or not coverage had actually changed for graduate workers, insisting that this was an individual mistake. After a protracted fight to get MIT and the insurance provider to acknowledge that the charge was unfair, MIT promised that the charges would be covered. Despite these assurances, weeks later, the $3,000 charge still has not been reverted.

Repeatedly receiving enormous medical bills can threaten graduate workers’ ability to focus on research, fully participate in the MIT community, complete their degrees, or even meet their basic needs. Graduate workers living with chronic health conditions or facing a sudden medical emergency should not be saddled with the additional burden of worrying about their insurance coverage, struggling to come up with the money to cover the cost of treatment, or fighting to overturn wrongful charges or to access relief funds. Moreover, all graduate workers still lack coverage in several basic areas of care, and more unexpected changes to insurance policies are still possible without a collectively bargained contract.

MIT lags behind peer institutions on health benefits, and particularly behind universities where graduate workers have unionized. For example, graduate workers at the University of Michigan secured dental coverage in their union contract in 1983 and also enjoy vision coverage, which is not currently available to MIT graduate workers. Meanwhile, at MIT, the GSC has been asking that MIT provide dental insurance to graduate workers for decades, to no avail. Instead, many MIT grad workers go without dental insurance, or pay out of pocket over $500 every year.

Previous advocacy efforts organized by the GSU have demonstrated the power of collective action to win expanded healthcare coverage for graduate workers. Prior to the GSU’s Mental Health Campaign (then operating as Grad Students for a Healthy MIT), graduate workers only received coverage for 12 therapy sessions per year, after which they incurred a $25 copay per session. For anyone receiving weekly therapy, this cost quickly became prohibitive, adding up to over $1,000 a year. We organized to harness our collective power and successfully pressured MIT to expand mental health coverage. We won 52 fully-covered therapy sessions per year, plus expanded benefits for antidepressant drugs, trans-inclusive healthcare, and more. But there is still a long way to go to ensure comprehensive, affordable healthcare coverage for all graduate workers, including those with chronic conditions, like Alex.

By coming together to form a union, graduate workers will finally have a democratic voice at the table to advocate for fair healthcare coverage. Forming a union is about workers standing in solidarity with one another to ensure that everybody’s needs are met — that means making sure that everyone can afford to take care of their physical and mental health and that no worker has to face the panic of a bill they can’t afford on top of a medical emergency.

With our union, we will have the collective power to fight for the healthcare we need. 

Join us by signing your union card at mitgsu.org/sign

If you are experiencing similar issues with healthcare as a graduate worker, please contact the MIT GSU at contact@mitgsu.org. 

Ethan Baker is a 5th year graduate student-worker in Biology.
Owen Leddy is a 3rd year graduate student-worker in Biological Engineering.
Sneha Kabaria is a 2nd year graduate student-worker in Chemical Engineering.

All authors are organizers for the MIT Graduate Student Union.