Expanding Health Care Coverage

Grantee Name

Consumers Union of United States, Inc

Funding Area

Expanding Health Care Coverage

Publication Date

December 2012

Grant Amount


Grant Date:

April 2011 – October 2011


Among other goals, Federal health care reform seeks to expand access to quality, affordable health insurance coverage.

Achieving that goal hinges on well-functioning insurance markets and consumers understanding the health insurance options available to them. To promote informed decision-making, the Affordable Care Act requires health insurers to use a new, standardized Summary of Benefits and Coverage form (Summary) to convey the benefits and cost-sharing provisions of their health plan offerings. A required component within the Summary is a consumer aid called the “Coverage Facts Label.” The Label will take traditional health plan information and calculate what consumers would have to pay out of pocket under different medical scenarios.

With support from the New York Health Foundation and the Missouri Foundation for Health, Consumers Union conducted testing of the Coverage Facts Label prototype to answer questions regarding how the Label would help consumers understand their health benefits coverage.

Outcomes and Lessons Learned

  • Partnered with an experienced moderator, Kleimann Communication Group, and tested two alternate designs for the label.
  • Conducted consumer testing in two cities—St. Louis, MO and Buffalo, NY.
  • Inspired a similar, smaller-scale testing initiative by America’s Health Insurance Plans and the Blue Cross Blue Shield Association.
  • Submitted a report, “Early Consumer Testing of the Coverage Facts Label: A New Way of Comparing Health Insurance,” to the National Association of Insurance Commissioners.
  • Produced a video to illustrate the study findings before a variety of audiences.

Read the report associated with this grant, “Early Consumer Testing of the Coverage Facts Label: A New Way of Comparing Health Insurance.”