Welcome to Consumer Reports Advocacy

For 85 years CR has worked for laws and policies that put consumers first. Learn more about CR’s work with policymakers, companies, and consumers to help build a fair and just marketplace at TrustCR.org

Empowering consumers in a new health insurance marketplace

CU outlines needed reforms to help consumers get good, quality coverage

Empowering Consumers in a New Health Insurance Marketplace

Health insurance reform should include:

■ An insurance “exchange” or “connector,” offering a choice of plans, that will:

√ Limit excessive variations in benefit design so that plans compete more on price and quality

√ Require information on price and quality to be presented in user-friendly formats

√ Include an optimal number of plan choices – not too few and not too many

√ Require plans to provide year-long benefit, price, and provider network stability

√ Protect against marketing abuses and punish insurers that mislead consumers

√ Ensure consumer co-payments for out-of-network care are based on honest, audited data

√ Make consumers fully aware of their rights to register complaints about health plan service, coverage denials, and balance-billing and co-pay problems, and to appeal coverage denials

■ A new Office of Consumer Health Insurance Education and Information that will:

√ Provide general and comparative information about insurance issues and policies using consumer-friendly formats

√ Require standardization of insurance definitions and forms so consumers can easily compare policies on an “apples-to-apples’ basis

√ Require insurers to clearly state (in standardized formats) what’s covered and what’s not in every policy offering, and to estimate out-of-pocket costs under typical treatment scenarios

√ Maintain an insurance information and complaint hotline, and compile federal and state data on insurance complaints and report this data publicly on a Web site

√ Institute and operate quality rating programs of insurance products and services

√ Manage a greatly expanded State Health Insurance and Assistance Program that would provide technical and financial support (through federal grants) to community-based non-profit organizations providing one-on-one insurance counseling to consumers