From individual consumer problems to large-scale policy change: Highlighting the work of the Health Consumer Alliance in California

How does a small group of health law advocates improve access to care for 36 million Californians? The answer lies in the operations of the Health Consumer Alliance (HCA), a network of nine legal aid agencies and two health law support agencies that have been working together since 1999. Health Advocates provide individual assistance to low-income consumers in 13 counties regarding health insurance and access issues. Client cases are entered into a central HCA database and analyzed regularly to identify trends and direct current policy needs to improve access to care. The HCA has assisted over 80,000 consumers and has converged to address dozens of health policy issues within California's complex political landscape.

An earlier evaluation of the HCA demonstrated that this independent network of legal advocates is effective in resolving consumer problems. Now, this phase of the evaluation is designed to illustrate HCA's critical role in health care advocacy and policy. HCA advocates meet regularly to discuss statewide policy issues, which has resulted in numerous work groups, 35 consumer brochures available in multiple languages, more than 50 advocate issue briefs, 12 policy briefs, thousands of trainings, various local and statewide networks, and development work among partners to secure funds for new projects.

This evaluation study will provide three examples of policy work derived from individual consumer cases, using our customized policy tracking instrument. We will highlight cases addressing charity care, Medicare Part D, and the HCA's response to Governor Schwarzenegger's health care proposal.