New Report Calls for a Pro-Consumer Health System

Posted January, 20 2011 by arianne

HCFANY member-organization Citizen Action of New York released a new report today which outlines how state implementation of the Affordable Care Act (ACA) can be used to establish a “pro-consumer” health system.   Written by the Public Policy and Education Fund of New York, the report makes numerous recommendations for  implementing the ACA here in New York, focusing on five major areas: 1) consumer-oriented governance; 2) consumer assistance; 3) affordable health insurance rates; consumer rights; and 5) reduction of racial and ethnic disparities in health care.

Among the major recommendations are the the following:

  • Strong consumer representation on the governing board of the New York insurance exchange, the health insurance “marketplace” that must be created by the state by 2014;
  • Aggressive consumer enforcement through a significant increase in penalties that may be recovered by the State Insurance Department against health insurers that violate the new federal law, as state exchange that can exclude health plans that sell lower quality products, and a strong role in enforcement by the new Attorney General Eric Schneiderman;
  • A permanent independent consumer assistance office to coordinate community-based organizations across the state to assist consumers with disputes with health insurance, enroll consumers in health insurance, and help them select insurance plans;
  • Reform of the health insurance regulation system that was reinstituted in New York in 2010  to allow consumers to meaningfully participate in rate proceedings;
  • Expansion of consumer rights by allowing consumers harmed by serious violations of health insurance laws to recover their damages in court (known as a “private right of action”); and
  • Reduction of health care disparities based on race, ethnicity, and other factors by designating a single state entity to oversee collection of disparities data and to make this information available to the public at no charge thorugh the internet.

Click here to read the full report.