Consumer Assistance Program

Many states offer help to consumers with health insurance problems. The Affordable Care Act improves these services with grants that help states start or strengthen Consumer Assistance Programs (CAPs). The states and territories that applied for these grants have received funds provide residents direct help with problems or questions about health coverage.

Get Direct Help with a Problem or Question

Whether or not your state has a Consumer Assistance Program, you have rights under the health care law, including the right to appeal decisions made by your health insurance provider.

If your state does not have a Consumer Assistance Program, some state and federal government offices may still be able to help you determine your rights and solve problems. Click the above link to find resources and contact information that may provide this help.

Find consumer assistance in your state

What This Means for You

Before the health care law, you often had to fend for yourself when trying to find affordable health insurance or resolve problems with a health plan. Even in states with programs to help consumers, those programs often have been overburdened and underfunded.

Now, federal grants are helping states and territories build Consumer Assistance Programs that offer more hands-on assistance to more people. These programs can help you:

•   File complaints and appeals.
•   Enroll in health coverage.
•   Get educated about your rights and responsibilities.

These programs also collect data on the types of problems consumers are having. They will file reports with the Secretary of the U.S. Department of Health and Human Services to identify trouble spots that may need further oversight.

Some Important Details

Evidence shows that hands-on consumer assistance programs resolve complaints and appeals effectively:

•   In 2009, one state program recovered more than $1.4 million on behalf of consumers.
•   Another state program recouped $20 million.

In addition to helping consumers with immediate problems, Consumer Assistance Programs will help consumers understand other health care reforms designed to make the health insurance marketplace more competitive and patient-centered in 2014 and beyond.

For More Information

•    Contact the Consumer Assistance Program in your state.
•    Find detailed technical and regulatory information on Consumer Assistance Program grants.
•    HealthCare Blog: Consumer Protections: Applying New Protections to Your Health Plan.
•    Fact Sheet: Helping States Give Consumers Greater Control of Their Health Care.
•    Find out which states and territories have applied for CAP grants and received funds.

Posted on: July 12, 2010

Last updated: January 25, 2012