Before and After 2014: How Consumer Assistance Programs Help Make Health Reform Work

Abstract: The first wave of health reform provisions have rolled out: dependants can stay on their family's policy up to age 26, lifetime limits are history, the high risk pools are insuring people with pre-existing conditions, and Medicare is covering preventative services. These are but a few of the immediate benefits of health reform. But what use are these benefits if consumers can't access or understand them? Cue the CAPs: Consumer Assistance Programs are poised to educate, empower, and assist consumers in their own language and in their own communities as they navigate an ever more complicated healthcare system. One such CAP is The Community Health Advocates (CHA) Program, housed at the Community Service Society. Under the Affordable Care Act (ACA), CHA is administered by the New York State Department of Health and has a network of 24 community-based organizations (CBOs) throughout the State. These CBOs conduct quality education workshops and individualized counseling for people accessing health care services. The program is culturally and linguistically diverse, providing information in multiple languages. The CBOs are trusted resources in their communities, and people who might not traditionally seek assistance for health issues go to them for help. In the new HHS Exchange Establishment Grants, CAPs are one of the core areas that states must fulfill in order to have their exchange approved. Clearly, CAPs are crucial in the implementation of health reform, both leading up to 2014 as provisions go into effect incrementally, and after 2014 to help consumers navigate the exchanges.