Interscholastic Athletics

Because participation in sports carries the risk of injury, some students who lack health insurance may be unable to participate in school-based athletic programs. GAO found that 28 percent of high school students in Texas and six percent in Massachusetts are uninsured. GAO could find no national, state, or local data on uninsured students who have been prevented from participating in sports. Although 10 states and the District of Columbia require student health insurance before joining an athletic program, 39 other states leave the decision to the local district. Sixteen of the 18 school districts GAO reviewed provided free catastrophic athletic accident insurance to all students. Two districts were self-insured. All school districts reviewed had adopted strategies to provide access to low-cost athletic insurance. In eight school districts, free supplemental athletic accident insurance was automatic; in nine school districts, parents had the option of buying low-cost athletic accident insurance. One district covered all medical costs of an athletic-related injury. Private hospitals and clinics sometimes help local school districts by offering free medical services for sports-related injuries.

GAO noted that: (1) in 1998, an estimated 3.4 million uninsured children were of high school age; (2) among highly populated states, there were wide differences in the percentage of uninsured children of high school age; (3) GAO was unable to identify any national, state, or local information on the extent to which these high school students were prevented from participating in athletic programs because they lacked basic health insurance; (4) the officials of the 51 athletic associations GAO surveyed were unaware of any instance in which a high school student was prohibited from playing high school sports because he or she lacked health insurance; (5) however, according to these officials, while 10 states and the District of Columbia require high school students to have health insurance before joining a school's athletic program, the other 39 states leave this decision to the discretion of local school districts; (6) in 17 of the 18 large school districts, district policy required student athletes to have health insurance to participate in high school sports; (7) in addition, many of these districts required student athletes to document insurance coverage before participating in sports; (8) however, school officials in four of these large districts reported that they did not have the resources to monitor the accuracy of health insurance information before or during a sport's season; (9) 16 of the 18 school districts provided free catastrophic athletic accident insurance to all student athletes regardless of their insurance status; (10) in most cases, the catastrophic accident policy would cover all medical costs once a family's expenses exceeded $25,000; (11) further, in all school districts GAO reviewed, local schools have adopted strategies to provide access to low-cost athletic accident insurance to student athletes; (12) in eight school districts, free supplemental athletic accident insurance was automatically provided to all student athletes; (13) in nine districts, the families of student athletes were given the opportunity to purchase low-cost athletic accident insurance; (14) school officials in these districts reported that instances of uninsured student athletes requiring athletic accident care were addressed through such activities as accident trust funds established at the school district level and through direct community involvement; and (15) private organizations such as hospitals and clinics assisted local school districts by offering free medical services to student athletes for sports-related injuries and other services such as pre-participation physicals or injury evaluation.