Across the U.S., historically Black colleges and universities (HBCUs) serve a disproportionate share of low-income and first-generation college students, often with far fewer resources than their predominantly white institutions (PWIs) counterparts. 

At the same time, HBCU students frequently report stronger mental health outcomes than their peers at PWIs. Driven in part by strong community, shared lived experience, and cultural affirmation, nearly 50% of HBCU students report “flourishing mentally,” alongside lower rates of anxiety, eating disorders, and substance use.  

But mental health resilience doesn’t translate to equitable healthcare access. When students need medical, behavioral, or specialty care, institutional gaps become visible — especially at smaller or underfunded universities without campus health system affiliations. As a result, healthcare access varies widely from campus to campus: 65% of HBCUs offer comprehensive on-campus health services with a prescribing provider, while 13% offer no student health services at all. 

When access is uneven, the burden shifts to students. Off-campus referrals, transportation challenges, or limited access to specialists compound existing barriers — especially for those managing chronic conditions or ongoing care needs. Under these pressures, a university-wide student health plan can be a critical strategy to close healthcare gaps and strengthen outcomes.

 

New pressures shaping student healthcare in 2026

A few federal and market shifts now in effect add complexity for students and families managing already tight budgets. They are:  

  • Medicaid limitations for out-of-state students
    Because each state has its own Medicaid eligibility requirements, students who rely on Medicaid at home cannot transfer their coverage to a new state. If a student is attending school away from home, reapplying for Medicaid requires terminating their original coverage; resulting in both reduced care when they travel back and forth from school to home and another waiting period for coverage approval. 
  • Shrinking marketplace subsidies
    ACA subsidies expired at the end of 2025, and many families now face higher premiums and increased out-of-pocket expenses. Plans that were once affordable no longer work for students living away from home.

Consider a student from Los Angeles attending an HBCU in Alabama while enrolled in a local California HMO plan. If they suffer an injury requiring ongoing treatment or physical therapy, access to in-network providers near campus may be limited or completely unavailable.

  • Employer-sponsored plan changes 

Employer healthcare costs continue to rise, pushing more expenses onto employees and their families. Employer-sponsored plans increased 8.5% in 2025 and are expected to grow again at the same rate in 2026, with pharmacy costs rising an additional 2.5% as well. For similar coverage, more families are electing to have their college students enroll in the campus student insurance plan with robust benefits.

 

Why student insurance matters for HBCUs 

Making student health plans a mandatory part of tuition can also improve equity and broaden access. Roughly 90% of HBCU undergraduates receive financial aid, which opens new pathways for students to use existing aid, grants, or loans to cover costs associated with a required health plan. 

Equally important, consistent access to healthcare—including behavioral health—helps drive overall retention and academic success. When students can access care early, easily, and on their terms, they’re far less likely to disengage or leave school due to health issues. 

For HBCU healthcare administrators looking to enhance student care, a comprehensive student health plan is among the most effective tools available. A strong program can:

 

Partner with Venbrook  
As federal healthcare changes reshape access in 2026, now is the right time to evaluate how student health plans can support healthcare equity and drive positive outcomes. Venbrook’s Student Insurance team works with HBCUs to evaluate existing programs, benchmark plan design, and develop solutions tailored to each campus community. 

Will you be attending the 2026 ACHA HBCU Coalition Summit? Venbrook’s Jasmine Johnson will be! Reach out to Jasmine at jajohnson@studentinsuranceusa.com to continue the conversation in person.