« June 2012 Issue

Celebrating a Victory for Consumer Assistance

Earlier this month, the Department of Health and Human Services (HHS) announced that it will provide nearly $30 million in additional funding for states to apply for Consumer Assistance Program (CAP) grants. The Affordable Care Act (ACA) initially funded these programs in 2010, however it was difficult to secure future funds due to Congressional deadlock. The additional funding is an important victory for consumers as these programs provide vital services to support people throughout the often-confusing process of purchasing insurance coverage.

"Too often, consumers are shut out, confused and frustrated by our complex and fragmented health care system," said Christine Barber, a senior policy analyst who leads Community Catalyst's consumer assistance work. "The system leaves many without the right health coverage and without the right information about what is available to them."

Through these programs, states and non-profit partners can help consumers bridge the gap, connecting people to coverage and helping them understand their insurance options. According to an HHS report, state CAPs successfully helped more than 200,000 individual consumers in the first year of the program. The programs generated more than $18 million dollars in savings on behalf of consumers - meaning insurance companies covered services that otherwise would have been paid for by consumers.  

One Massachusetts consumer's story exemplifies some of the benefits CAPs provide that cannot be measured - assurance and peace of mind. A six-year-old boy was given the opportunity to be weaned off his feeding tube for the first time in his life through an eight-week inpatient program, but his insurance company denied the claim. His mother turned to Health Care for All's consumer assistance helpline, which connected her to Health Law Advocates, a public interest law firm. Health Law Advocates helped her appeal to the insurance company, and, ultimately, she got her son into the inpatient program. With this assistance, she says, she was empowered to be her son's voice when he didn't have one - something she says she would not have been able to do on her own. 

The announcement of the additional funding for CAPs is an important achievement. Support for consumer assistance is a priority for Community Catalyst, and we worked closely with federal lawmakers to ensure it was incorporated into the Affordable Care Act. Since the initial funding period, we have continued to work with our state partners to advocate for additional funding at the federal level.

"Funding for CAP is a critical component of giving consumers more information about and control over their health care," Barber added.

This continuation of funding is a step toward guaranteeing states are prepared to meet the needs of the millions of newly eligible people applying for insurance in 2014, some for the first time in their lives.