Making Coverage Count: States Establish Consumer Assistance Programs

September 23rd marked 18 months since enactment of the Affordable Care Act. As showcased on State Refor(u)m, states are in the midst of implementing provisions that are expected to expand health coverage to millions of Americans. One component in making coverage count are grants for state consumer assistance programs. These programs educate insured consumers about their rights, assist them in filing complaints and appeals, and collect data about consumers’ experiences with their health coverage. Consumer assistance programs will also help consumers resolve problems in obtaining subsidies for coverage through the Exchange in 2014.
In order to support these programs, the ACA provides grants to states to start new programs or bolster existing ones. Last October, nearly $30 million in consumer assistance grants were provided to 35 states, four territories, and the District of Columbia. The map below provides an overview of states that are developing consumer assistance programs, states that have already developed them, and states that have not yet developed a program.

Source: Healthcare.gov
States that received consumer assistance grants last year are taking a variety of approaches to improving the consumer experience. For instance, 26 states plan to conduct outreach campaigns, 24 states will provide education and assistance directly to consumers, and 16 states plan to establish a call center. A full list of activities that states are working on is available here, but here are a few highlights of what they have planned.

• Pennsylvania is creating a statewide education and outreach program about the ACA, in addition to implementing new online enhancements that will allow consumers to track their complaints and questions through the insurance department.
• Kentucky is hiring additional staff to meet with consumers and help them understand their health insurance options. The state is also enhancing and expanding its databases to include more detailed information on issues that consumers face and allow staff to capture information about access, affordability and coverage that they may encounter in their work.
• New York has contracted with the Community Service Society of New York (CSS) to run the state’s program. Through a network of community-based organizations and telephone help lines, CSS provides assistance for residents as they navigate the state’s health system. A newreport, issued by the New York State Health Foundation, explores some of the issues in establishing a consumer assistance program and examines its relationship with the Navigatorprogram.
• Michigan is planning to conduct town hall meetings across the state and create public service announcements to increase awareness of services. The state also plans to conduct an evaluation of its consumer assistance efforts.

As the details of the Exchange become solidified and states begin enrollment, consumer assistance programs will become an integral component to ensuring that health coverage is working for consumers. Given that states are taking a variety of approaches to consumer assistance, we encourage you to share your state’s experience on State Refor(u)m.