Consumer Assistance Needs Before and After the Affordable Care Act

People standing and waiting in a line.

Researchers look at issues people have reported to Consumer Assistance Programs (CAPs) in 10 states and identify trends during three distinct periods: before, during and after the implementation of the Affordable Care Act (ACA).


The Issue 

CAPs are designed to help people resolve issues with their health insurance options. They also play an important role as the first line of gathering information regarding problems consumers experience with their insurance.

Key Findings

  • Before the ACA’s passage, consumers primarily reported issues about being denied private health insurance because of pre-existing conditions or facing premiums that were too expensive.

  • During the implementation of the ACA, consumers reported issues with technology glitches of the marketplace websites, or had questions about how the subsidies worked.

  • After the ACA’s implementation, consumers reported issues of unexpected high deductibles, as well as questions about their eligibility or ineligibility for marketplace subsidies.


CAPs serve an important feedback gathering function that can help officials and legislatures improve health insurance programs on an ongoing basis. This report identifies issues like low levels of health literacy and awareness of marketplace eligibility that can still be improved.

About the Grantee

The Center on Health Insurance Reforms at Georgetown University’s Health Policy Institute is a nonpartisan, expert team of faculty and staff dedicated to conducting research on the complex and developing relationship between state and federal oversight of health insurance markets.