Nonprofits Can Help Consumers Who Are Struggling to Pay Health Insurance Premiums

The Affordable Care Act has made immense strides in expanding access to affordable health coverage. But some lower and moderate-income consumers may still struggle to afford coverage and care, even with the help of federal financial assistance. Nonprofits can alleviate some of the burden facing consumers.

Last week, we highlighted forward-thinking solutions some states have implemented to provide greater financial assistance to consumers, such as implementing the Basic Health Program.

Some nonprofit organizations have also started developing private financial assistance programs to help pay the monthly premiums and out-of-pocket costs for lower-income consumers’ marketplace coverage, many with funding help from their local health care systems. And earlier this year, the Department of Health and Human Services issued guidance in support of such nonprofit efforts.

Today, we share how two nonprofits in Wisconsin and Oregon have worked with their local health care systems to provide additional financial assistance with the cost of marketplace coverage to lower- income consumers.

• In Wisconsin, the United Way of Dane County has established a premium assistance program—Health Connect—through funding from University of Wisconsin Health. The program covers the remaining portion of a consumer’s monthly marketplace premium that is not covered by federal financial assistance. The program is open to any Dane County resident who has an income between 100 and 150 percent of poverty.
• In Oregon’s Portland Metro area, the nonprofit Project Access Now raised more than $400,000 from all Portland-area hospitals to fund a premium assistance program for residents who are under 200 percent of poverty. The program pays the remaining portion of a consumer’s marketplace monthly premium not covered by federal financial assistance, and the hospitals and other community providers agree to cover the remaining out of pockets costs after insurance payments are made.

Long term, we need state and federal policy solutions to tackle remaining health insurance affordability problems.

But in the interim, as demonstrated by these two programs, nonprofit financial assistance programs can serve as a vital safety net for many low-income consumers.