When on January 1st the insurance markets open up with new formats and prices, the people are going to need help figuring it all out. Especially for the job-based and individual plans which will have to be understood.
21 States and the District of Columbia have consumer assistance programs in place which can handle all queries and aspects of private health insurance. The funds from the Affordable Care Act have funded these programs.
Some Republican led States did not apply for Federal funds, and they now face constraints on funding these programs. There are few community based organizations which have offered to assist with health insurance issues.
The online health exchanges will have navigators to take people through all the available options and there will be toll free numbers, to answer queries and offer help.
The extent to which comprehensive assistance is available, however, may vary widely by state. "Particularly because a lot of states have taken an oppositional approach [to the ACA], there are a lot of questions about where consumers should go with questions," says Sabrina Corlette, a research professor who directs Georgetown University's Center on Health Insurance Reforms. "A lot of it is unsettled right now."
There are still many unresolved issues, like co-payments for tests and screening under the Consumer Health Program. Under the Affordable Care Act - all screenings recommended by the U.S Preventive Services Task Force do not require co-payment by the patients.
Funding for the national Consumer Assistance Program is a question as the federal Department for Health and Human Services granted $30 million in August 2012. It is not very clear if and how much additional money will be granted to keep such programs running.
Elisabeth Benjamin, vice president for health initiatives at the Community Service Society of New York, of which Community Health Advocates is a program.
"Our job is to be squarely on the consumer's side," she says. "These are the worker bees of the ACA."
Hannah Punitha (IRDA Licence Number: 2710062)
Michelle Andrews, June 2013