Affordable Care Act (ACA) Consumer Assistance Program Grants | Apply Online

Opportunity Summary:

The Affordable Care Act (ACA) Consumer Assistance Program (CAP) Grants are discretionary federal grants administered by CMS Consumer Information and Insurance Oversight to help states build or strengthen consumer-focused assistance services related to health insurance. The core purpose is to make it easier for people to understand their coverage options, enroll in appropriate health coverage, and navigate common insurance problems when they arise. These programs are designed to function as a practical, front-line resource for consumers who need help with health plan questions, coverage disputes, or understanding what protections and responsibilities apply to them under the law.

A central part of the grant-funded work is direct consumer support. States use CAP funding to help individuals file complaints and pursue appeals with insurers when coverage is denied or when consumers believe their plan is not following applicable rules. The programs also support consumer enrollment into health coverage, which can include helping people understand plan choices and complete enrollment steps. Another major requirement is consumer education: CAP entities must educate consumers about their rights and responsibilities, helping them better understand benefits, costs, and protections so they can make informed decisions and avoid common pitfalls.

Beyond individual case assistance, the grants have an oversight and improvement function built into the statute. CAP programs must collect and report data on consumer inquiries and complaints. This information is used to help the Secretary identify patterns and recurring issues in the health insurance marketplace, which can guide stronger enforcement and policy responses. In other words, the grants support not only one-on-one problem solving, but also a feedback loop that highlights systemic problems affecting many consumers.

The opportunity also reflects the ACA marketplace context. Starting in 2014, CAP programs are required to help consumers resolve problems involving premium tax credits for Exchange coverage. That means these consumer assistance offices are expected to help people address complications tied to financial assistance for marketplace plans, such as questions or disputes that can arise when premium credits are involved.

Funding details in the announcement indicate an estimated total funding level of $29,000,000, with an anticipated 56 awards. Individual awards range from a floor of $120,000 up to a ceiling of $3,400,000. There is no cost-sharing or matching requirement, which means states are not required to contribute additional non-federal funds as a condition of receiving the award.

Eligibility is limited to state governments, but with a specific structural requirement: participating states must designate an independent office of health insurance consumer assistance or an ombudsman that meets the program criteria. States have flexibility in what entity fills this role. They may designate an insurance department, a state attorney general office, an independent state consumer assistance agency, or another appropriate state agency. States may also contract or enter into agreements with one or more nonprofit organizations, including a nonprofit consortium, as long as the arrangement meets the grant requirements and the designated program functions as the independent consumer assistance resource envisioned by the law.

Key administrative details from the notice include the funding opportunity number CA CAP 10 002, CFDA number 93.519, and categorization under the health funding activity area. The opportunity was posted and created on July 22, 2010, with an original and current closing date of September 10, 2010, and an archive date of October 10, 2010. For applicants or members of the public who have trouble accessing the full announcement electronically, the listing points to the Grants.gov Contact Center (1-800-518-4726, Monday through Friday, 7:00 a.m. to 9:00 p.m. Eastern) and support@grants.gov for assistance.

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