“For decades, our country’s health insurance industry has operated in the shadows,” HHS Secretary Kathleen Sebelius said during a Thursday call with reporters. “As a result, when someone had an issue with a claim or trouble understanding a benefit they often felt alone or confused or taken advantage of.” But state agencies and local not-for-profits contracted by states have helped more than 200,000 people understand their insurers’ policies and their own rights, as well as filing appeals when they were denied coverage. That assistance led consumers obtaining $18 million in direct savings and “millions of dollars more in unquantifiable savings from better coverage,” according to HHS.
Overall, about one-quarter of the cases filed by the assistance programs have closed and among those more than 75% were resolved in the consumer’s favor.
Also, the grantees provided consumer education and helped uninsured consumers find health insurance coverage, including enrollment in the federal pre-existing condition insurance plan.
It remains unclear whether the states will have to develop their own ongoing long-term funding for the assistance programs or whether additional future federal funds will become available, Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at CMS, told reporters.