Stanford’s changes to Cardinal Care are costing some graduate workers 40,000 dollars.
Just a few months since Stanford’s newest version of Cardinal Care was implemented in September, large cracks have already formed in the healthcare coverage for graduate workers. Under the new plan, copays have increased by 40%, out-of-pocket maxima by 50% and emergency room visit costs by a staggering 250%. Receiving covered care, such as a simple eye exam, involves a complex reimbursement process. Workers are required to front costs out of their own wallets at the time of care, money many do not have. Many workers have been forced to suffer through long wait times at Vaden Health Center just to obtain new referrals for previously approved treatments, leading to monthlong delays in necessary care. Others have been kicked off their chosen provider entirely, causing critical disruptions to time-sensitive or recurring treatments. These widespread disruptions are alarming in their own right, but for some graduate workers, the consequences of the new plan are far more severe.
The University’s chosen insurance plan now excludes a number of previously covered “specialty medicines and treatments” from the $3,000 annual out-of-pocket maximum, exposing students to catastrophic medical expenses. One student has reported that their specialty medicine, Bimzelx, now costs them $3,000 per month ($36,000 a year), a cost that does not even count towards their annual out-of-pocket maximum. Under Stanford’s plan, this person will pay north of 60% of their stipend just to manage debilitating pain.
Another worker reported that a specialty care item costing $25 under the previous Cardinal Care administrators (HealthNet and Aetna) will now cost them $3,000 per treatment. These workers and others in similar situations face a dire reality. With their medicines now costing half their yearly salary — the minimum stipend for graduate workers on a 50% appointment is $56,348 for 2025-26 — they are forced to choose between incurring substantial debt, compromising basic needs like rent and food or discontinuing essential treatments.
During the 2024 contract campaign, the Stanford Graduate Workers Union (SGWU) Bargaining Committee proposed a “continued quality of care” provision. This catch-all clause, common across labor contracts with existing healthcare benefits, would have forced Stanford to maintain the quality of our healthcare. Unfortunately, Stanford rebuffed any language codifying healthcare benefits. The administration refused to even discuss retaining equivalent quality of healthcare.
An imperfect compromise was reached: Stanford would remain free to alter its healthcare, and differences between copays and coverage would be handled by Emergency Grant-In-Aid (EGIA). But the costs of these changes to graduate workers are an order of magnitude more than EGIA is designed to cover. What once looked imperfect has revealed itself to be completely untenable.
Stanford has an obligation to honor its commitments in bargaining; they must provide aid to cover these new costs. It is the ethical bare minimum to not force people to choose between quitting their degree, enormous medical debt to afford necessary medications and treatments or their health.
We call on Stanford to immediately cover the costs for workers whose health and financial stability are in jeopardy due to this ill-managed insurance change. To do otherwise is a betrayal of the University’s duty towards its workers and a confirmation that their promises of compassion are empty words.
Stanford must act now to support affected graduate workers. It is unsustainable to continually have our healthcare coverage rearranged with no control and little warning. Every unilateral change Stanford makes results in people going without medicine while waiting for bureaucratic approvals, changing their practitioners and now paying thousands of dollars in medication costs. The Stanford administration must take the needs of graduate workers into consideration before making these decisions. They have shown time and again that unless forced to listen, they won’t.
As we look forward to the fight for our next contract, we must ensure it guarantees adequate healthcare for graduate workers. Health insurance guarantees are the norm in union contracts across industries and Stanford should not be an exception. Soft agreements and assumptions have only led to a diminishment of care; Stanford must demonstrate they are willing to commit to continued quality of healthcare for all graduate workers before they lose the very people who make this university run.
Liam Sherman is a physics Ph.D. candidate and is the SGWU Vice President for Membership. Helene Koumans is a chemistry Ph.D. candidate and is the SGWU Campus Chief Steward.
This piece is also co-signed by SGWU organizers Artem Arzyn, a computer science M.S. candidate, and Ben Alexander, a physics Ph.D. candidate.