Consumer Assistance: A Guided Tour to Your New Health Care Choices – Say Ahhh! A Children’s Health Policy Blog

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By Christine Barber, Community Catalyst

We’ve all heard the recently-passed Affordable Care Act
(ACA) provides a lot of new opportunities for improving health care coverage
and access – but we also hear most Americans don’t understand what the law
actually means for them
. At Community
Catalyst, we think a major opportunity created by national health reform is
improving consumers’ access to clear information about their health care
options from trusted sources. Consumer assistance programs (CAPs) are a
critical way to make this happen.

The ACA included $30 million in grants for 2010 to fund
state CAPs and ombudsman offices (Section 1002) to help real people understand
their health care options. And the Department of Health and Human Services
Office of Consumer Information and Insurance Oversight (OCIIO) just released
the grant guidelines for
the program late last week. Overall, we at Community Catalyst applaud the

A few highlights:

  • The grant criteria take steps to ensure that the
    selected programs are independent. In particular, we are happy to see that the
    guidelines clearly welcome states to contract with non-profit organizations to
    provide consumer assistance.
  • CAPs must assist people with all types of coverage and
    provide assistance that is culturally appropriate. In addition, programs must
    collect data about any problems and questions, which we hope will provide
    real-time, on-the-ground information about what’s working and what’s not.
    Regular feedback to state and local policymakers can help improve health reform
  •  Each state is eligible for one grant award. Therefore,
    it is important that states know about this grant program, so consumers can get
    help, no matter their zip code.

Examples like Health Care for All Massachusetts’s Helpline,
New York’s Community Health Advocates,
and Health Assist Tennessee have shown us that
strong consumer assistance programs can mean the difference between a failed
attempt and successful reforms. The Helpline in Massachusetts saw their call
volume increase by 400 percent after Massachusetts’s health reform law passed.
People still call with questions, from enrollment assistance to help with
paperwork to navigating the health system.

We hope that states will partner with community-based
non-profits wherever possible to help provide consumer assistance. We have seen
these models work, and know that they are trusted sources of health care
information for communities and for families looking for help in understanding
a system that’s about to get bigger and more complex.

The CAPs grants are an important step in making sure the
public understands and can navigate the health system as it changes. Grant
applications are due September 10, and year-long grants will be awarded to
states this October.

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