A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Making Health Reform Work: State Consumer Assistance Programs

Making Health Reform Work: State Consumer Assistance Programs

September 16, 2010

Our colleagues at the Community Service Society NY and Community Catalyst have released a fantastic (and beautiful to look at too!) new report (pdf) that highlights the importance of State Consumer Assistance Programs (CAPs) in making health reform implementation work best for real people. Consumer Assistance Programs provide essential information and enrollment assistance to consumers looking for the best health plan for them. CAPs also help to ensure that people know how to use their health care coverage to access the care that they need. In addition to direct service, CAPs also provide a very important ‘sentinel function’, that is taking what they hear on the ground, and reporting back to policymakers, legislators, as well as other stakeholders in order to make systemic changes in the health care system.

According to the report, there are more than 100 CAPs currently in operation throughout the country. The report provides readers with overviews of four CAP models, including HCFA’s HelpLine as an example of the nonprofit community based organization HelpLine model. Other nonprofit CAPs highlighted included are Community Health Advocates in NY and the legal services model, California Health Consumer Alliance. The three other CAP models include non-profit/government hybrids or partnerships, government run programs, and private call centers. Examples of these models are also given.

As the report explains, an estimated 32 million Americans will gain health care coverage due to the passage of the Affordable Care Act. Navigating the nation’s current health care system is already extremely difficult for people. As health care coverage expansions that will be carried out across the country, people will need information and assistance in their communities. CAPs provide an extremely valuable service for all stakeholders in the health care system. States should look to existing CAPs as models for creating quality, affordable health care coverage for all.
-Kate Bicego