It was a first for Texas: a state office devoted to consumers struggling to find affordable health insurance coverage. With funds from the federal health reform law, the Texas Consumer Health Assistance Program was launched last January.
A $2.8 million grant allowed the state to hire nine employees to staff a toll-free hotline. More than 6,000 Texans called in during the past year, seeking advice on how to find affordable coverage, or help filling out an insurance application, or fighting a denied claim. The new employees traversed the state, hosting more than 160 events aimed at making Texans — a quarter of whom lack insurance — more aware of coverage options.
“The grant provided us with the opportunity to … actually take the 20 or 30 minutes, or however long, to help someone complete an application,” said Audrey Seldin, senior associate commissioner for consumer protection at the Texas Department of Insurance, which oversees the program.
But less than a year after it opened, the Texas Consumer Health Assistance Program is preparing to shut down, a victim of Congress’s inability to agree on a federal budget for next year. The nine employees are likely to be dismissed in April. The events will stop and the toll-free hotline will redirect to a general consumer assistance number at the Texas Department of Insurance, which deals with all kinds of insurance and has less expertise in health coverage.
Texas is among the 35 states that received health reform grants to build consumer assistance programs more than a year ago. The Affordable Care Act of 2010 set aside nearly $30 million to fund the program in 2010, which states have used to handle questions about how to obtain affordable health coverage or appeal denied insurance claims.
The health reform law also authorized future funding for the consumer assistance program, but left it to Congress to appropriate that money — in contrast to most other provisions in the law, which were automatically funded into the future. When the House and Senate failed to pass a budget last year, operating instead on a short-term fix that continued all existing appropriated programs, the consumer assistance program was shut out.
“I don’t know that, while health reform was being debated, any of us understood how hard it would be to get additional funding going forward,” said Christine Barber, a senior policy analyst with Community Catalyst, a Boston-based community advocacy group that has worked with many of the new programs.
Barber and other consumer advocates say the funding could not have run out at a worse time. The federal health reform law has left more Americans with questions about how health insurance is changing. Those are likely to increase as the law is expected to expand coverage to 32 million more Americans by 2019.
“I have a little bit of a nightmare about what will happen” when the funding runs out, said Victoria Veltri, who oversees Connecticut’s grant and is currently looking to the state or private foundations to continue her program. “I won’t stop searching for funding.”
Connecticut has run ads on television and the sides of buses letting residents know about its services, while Maine has begun representing those denied claims by insurance companies in appeals courts. Since the grant started, Maine Consumers for Affordable Care has netted consumers $23,000 in insurance appeals, with an additional $53,000 on the line in pending cases.
“We haven’t lost one yet,” Mia Poliquin Pross, associate director of the Maine consumer assistance program, said of the claim denials her two attorneys have appealed. “We would really like to ramp up that portion of the work.”
The consumer assistance programs have also served as an informal monitor of health insurance materials and policies, often tipped off by consumers’ questions. Multiple states, including Massachusetts and New York, have reported back to the federal government certain insurers that are out of compliance with a given health reform provision, or are incorrectly advertising their services.
As many states expect to exhaust their funds in the spring, they are preparing in different ways. A few, like Texas, have already decided to shut down their programs. The Arkansas Department of Insurance also plans to shut down its program, reassigning two employees funded by the grant to new positions.
Others are exploring how they might be able to move forward without federal funding. But the uncertainty of whether or not that will happen is already taking its toll: Massachusetts’ new outreach coordinator left when the state could not guarantee she would have a job next year.
“We expected these grants would be funded continually,” said Brian Rosman of Health Care for Massachusetts, which has run the state’s consumer assistance program. “To walk away now from the investment, that seems really counterproductive, given that we’re now getting closer to 2014. I would think these programs would be needed more than ever.”
Many running the grants expressed a similar frustration, not only over investing in a program that would be dismantled so quickly but also at increasing consumers’ awareness of the new departments, only to lose the capacity to handle increased call volumes.
Carla Obiol, a deputy commissioner at the North Carolina Department of Insurance, is managing a $1.2 million grant that allowed the state to create an ombudsman office devoted to handling health insurance issues that she describes as “consumer assistance on steroids.”
“It’s not just about handling complaints,” Obiol said. “We’re adding an educational element, so folks understand they have a right to appeal Þan insurance claim denialå and take advantage of that option.”
Obiol and many others are looking to other federal grant opportunities to continue parts of their programs. Funds to build new health insurance marketplaces, which will launch in 2014, do include some money for consumer assistance, although more limited in scope.
The Department of Health and Human Services is working with states to explore other sources of funding to keep their programs running.
Some states have managed to move forward with their programs, even after funding has run out. New York’s federal funding ran out at the end of October, but it has continued to run a consumer assistance hotline that serves all 62 counties across the state by using funds from the federal health exchange grant. In the past year, it has handled calls from more than 33,000 New Yorkers.
Same old dirty tricks by the corrupt GOP. They are despicable. Take the SAVE AMERICA pledge: I WILL NEVER VOTE FOR A REPUBLICAN EVER AGAIN.
Way to be open minded, that is just what our country needs to move forward.
As a former Republican, I’ve been open minded long enough to see that the Republican Party care ONLY for their Rich special interest constituents and will do NOTHING for me or the middle class. They blame the Prez for everything Bush caused and have obstructed and filibustered all efforts to fix the problems and are even pushing for JOBKILLING government cuts. The ONLY way to move this country forward is to get rid of the Republicans!
The Obama administration hasn’t passed a budget since he became president and he had a full democrat congress the first 2 years . So don’t put all the blame on the republicans.
Presidential administrations do NOT pass budgets.
Only Congress can pass a budget.
A president then signs it into law.
Please educate yourself as to how YOUR government works.
And it is the Republicans that want to do away with healthcare,
which is the subject being discussed here.
You are aware that the incoming president inherits the biennial budget already passed and in effect from the prior administration, right?
Or are you blaming Obama for “not passing” the last Bush budget when he took office?
You do understand that is nonsensical, right?
ALL the blame deservedly goes to the GOP, the ones who tanked the economy, the ones who obstruct and filibuster all efforts to fix it, the ones who ONLY work for the rich, and the ones STILL pushing for JOBKILLING government cuts.
Let’s not tax millionaires and billionaires.
It’s OK that Exxon, GE, Chevron (etc.) payed zero taxes last year.
Let’s not close corporate loopholes.
Let’s not bother the mega rich, because they might
decide to fund another candidate.
Instead let’s take healthcare away from poor people.
If Republicans have their way, Social Security is next to go.
What a caring, compassionate bunch.
There is nothing compassionate about using the force of government to coerce people into an unsustainable retirement system that is then simply used as a political wedge issue to threaten and intimidate both friend and foe alike, similar to what you’ve done above.
Wow. You are advocating for the elimination of Social Security!
That is reactionary and would result in many senior citizens freezing or starving to death.
Is that what is meant by “compassionate conservative”?
LMAO. Social security is “government coercion?”
You need to stop listening to hate media.
Why don’t you ask any of the tens of millions of people who depend on social security how they feel about the government “coercing” them to get a check every month.
You’re comments simply validate my point – that Republicans, given the chance, would do away with social security.
Then many seniors would go hungry or freeze to death.
I’m starting to think that’s part of the Republican plan.
Socialized medicine would eliminate the need for such expensive programs. Mountains of paperwork, insurance companies, ultra-rich doctors who are more interested in making piles of money, etc……..
Hey here is a idea. Get the government out of the process and let ALL insurance companies to offer insurance in Maine. Competition not government makes things affordable and better.
Insurance companies have never been restricted from offering policies in Maine.
Tyke is right. Insurance companies CHOSE not to sell insurance in Maine. Why? Because Maine required health insurance companies to cover some basic medical needs such as mammograms. It was the elimination of many such requirements that lured other companies to enter the Maine healthcare environment. So yes, deregulation brought in competition. But at the expense of important aspects of healthcare coverage. They charge slightly less in premiums and deliver a lot less in essential coverage.
As someone who uses the VA healthcare system and will be going on Medicare in one month when I turn 65, I’m grateful to have the government involved in my healthcare and you can bet there are millions more who feel the same as I do.
I too have been to the VA, and you can keep them.
There are more vets that rather have no insurance than be forced into one.
Yes the past 20 years of healthcare insurance company double digit premium increases aren’t enough, let’s let the insurance companies do anything they want…no regulations…have a free for all. AS IF that would work.
We do not need healthcare insurance, we need healthcare. All the insurance companies do is drive up the cost of healthcare. Eliminate the profit motive for healthcare and move to a single payer healthcare system.
Eliminate to obstructionist republicans and get government working
In 1993 the Republicans tried to pass healthcare simular to so called ” Obamacare” . Now that the Obama administration has passed it oh my god this is terrible it will be the ruin of this country. If a Republican president had done what the Obama adm. has accomplished the R”s would be building statues of the R. president and they would be bowing each time they went by it. Funny how things changed.
The GOP plan was more than similar to Obamacare, the Heritage Foundation penned plan itself became its bones.
The republicans lacking any principled argument resorted to distortion and misinformation. Unfortunately, about half of the people bought their BS.
The GOP lacks any real principles besides relishing power. Any issue they once stood for has become subservient to their quest for power alone.
Well said.
I dont care what party says what, I will never be forced into a healthcare plan,,,, ever..!
So you do not believe in the democratic process? Or is it only that you don’t believe in the democratic process if it is not convenient. I sense that you are a veteran and so I would be interested in your answer. Democracy is THE fundamental reason for the sacrifice our armed forces endure.
Like I said, I will never be forced. You can take any way you want, but no politician is going to force me, and there are plenty of us that are willing to back that up..!
So what does that mean, “there are plenty of us that are willing to back that up..!”? How would you “back that up”? Are you talking civil disobedience or armed resistance?
What are you, thick…?
3/4 of our country do not trust Congress, everyone can see the growing awareness of corruption within our government, we witness politicians that get away with crimes that would put any average citizen in jail for a very long time, more than half do not want mandatory healthcare,,, what do you think…
No part of our government hasnt totally messed up, or looted every aspect of what it touches, what makes you think that they wont skrew this up and leave it totally bankrupt and leave your medical records open to anyone that has a computer— Remember, this is the government that actually “had the launch codes for our missiles go missing over a weekend, and hadnt been noticed until monday” “had accidently left a live tactical nuke on an unloading dock”
You need to start to paying attention to how many countries are turning on their own governments for the exact things that are happening here. You cant live your life thinking it cant happen here.
I am not advocating anything, other than I will never be forced to join anything. If union “representatives” couldnt convince me to join, what chances do you think some corrupt politician will have getting me to comply.