Short Paper 1: The ACA and Consumer Assistance Programs

The Patient Protection & Affordable Care Act (PPACA) promises to bring about the most significant reforms to our health care system in more than a generation, affecting the financing, delivery, quality, and availability of health care services for all Americans.1 Recognizing that consumers will need to understand new health programs and new protections, section 1002 of the PPACA includes provisions to establish and strengthen consumer assistance programs across the country. On October 19, 2010, the U.S. Department of Health and Human Services awarded nearly $30 million in Consumer Assistance Program grants to 40 states, territories, and the District of Columbia.
This issue brief will provide information about the PPACA consumer assistance provisions. It will then highlight exemplary activities underway through the California-based Health Consumer Alliance, which NHeLP has led since 1998.
Explanation of PPACA Section 1002
Section 1002 of the PPACA added section 2793 to the Public Health Service Act to provide federal grants to States and Territories to establish, expand, or provide support for the establishment of independent offices of health insurance consumer assistance or ombudsman programs (CAPs).2 The CAPs will educate individuals about their insurance options and rights, help them enroll in an insurance plan, and assist them with complaints. The CAPs will also collect information and provide data about consumers? experiences using their health insurance.
The law appropriates $30 million dollars for the first year to fund CAPs starting in 2010 and authorizes future appropriations as necessary.3 On August 20, 2010, President Obama requested another $30 million in funding for a second cycle of consumer assistance grants for 2011.4
On July 22, 2010, the Department of Health and Human Services? Office of Consumer Information and Insurance Oversight (OCIIO) released an invitation to states to apply for the grants and laid out the grant requirements and application process.5 Applications for the first year funding were due on September 10, 2010,6 and, as noted above, the awards were announced on October 19th.

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