ObamaCare allies fear deal won’t mitigate Trump attacks

ObamaCare allies fear deal won’t mitigate Trump attacks
© Greg Nash

ObamaCare supporters are worried that President Trump’s attacks on the law will depress enrollment and confuse consumers, inflicting damage that can’t be fixed even if Congress comes up with a bipartisan health-care deal.

Open enrollment begins in less than two weeks, and advocates are bracing for a drop in the number of people signing up amid the Trump administration’s months-long campaign against ObamaCare.

Just last week, Trump canceled key ObamaCare insurer payments and signed an executive order on health care, moves critics say are attempts to weaken the law. 

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“I think you have to expect you’ll see less people on the exchanges,” said Sen. Chris MurphyChristopher (Chris) Scott MurphyDem senator: I support 'real' Second Amendment, not 'imaginary' one Frustrated Trump wants action on border wall, immigration Michigan Dem: Detroit-style pizza 'sweeping the nation' MORE (D-Conn.) 

“The president is working really hard to make sure enrollment numbers are as weak as possible,” he added.

Senate Health Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderSenate GOP urges Trump administration to work closely with Congress on NAFTA GOP lawmakers want Trump to stop bashing Congress The Hill's Morning Report - Sponsored by CVS Health - A pivotal day for House Republicans on immigration MORE (R-Tenn.) and ranking member Patty MurrayPatricia (Patty) Lynn MurrayOvernight Health Care — Sponsored by PCMA — Trump official won't OK lifetime limits on Medicaid Dems warn against changes to federal family planning program Overnight Health Care: Drug company under scrutiny for Michael Cohen payments | New Ebola outbreak | FDA addresses EpiPen shortage MORE (D-Wash.) on Tuesday announced a bipartisan agreement on a bill that would fund the insurer payments cut by Trump, but it’s not certain that bill will pass in time to have an impact on open enrollment — if it can pass at all. 

Trump has described the bill as a “bailout” of insurance companies, and Republican leaders in both the House and Senate have also expressed skepticism. 

Even if the bill does pass and is signed by Trump, it’s unlikely to happen before open enrollment begins in two weeks. It might not even pass before open enrollment ends Dec. 15, although Alexander said Wednesday he thinks it could pass by the end of the year. 

Critics also say it wouldn’t undo months of damage Trump and his administration have already done to the Affordable Care Act (ACA).

“From what I’m hearing on the Alexander-Murray deal, it is good news for insurers and consumers and could mitigate some of the damage done by the Trump administration,” said Emily Gee, a health economist at the Center for American Progress, a left-leaning think tank in D.C. 

“However, this open enrollment still remains an uphill battle. Recent polling reveals there’s a great deal of confusion about the marketplace among current enrollees and potential consumers, much of which has been stirred up by the administration’s campaign against the ACA, and any deal can’t change that overnight,” she said.

The discussion surrounding a new deal could actually add to confusion consumers are already facing over the law, thanks to a ten-month debate over repealing and replacing ObamaCare, rhetoric from Trump that the law is failing, insurer exits in many counties and executive orders signed by Trump. 

“I think it’s unlikely that the legislation will pass before Nov. 1, so this may simply add to the confusion,” said Jennifer Tolbert, an insurance expert at the Kaiser Family Foundation in D.C. “It is very hard to anticipate what will happen but all of these factors will possibly align to sort of create enough confusion among eligible consumers that fewer will sign up.” 

After canceling the insurer payments last week and signing an executive order that would allow the sale of less comprehensive health plans, Trump has declared ObamaCare “dead,” no doubt adding to any confusion felt by consumers. 

“ObamaCare is finished. It’s dead. It’s gone. It’s no longer — you shouldn’t even mention it. It’s gone. There is no such thing as ObamaCare anymore,” Trump said earlier this week.

On top of that, his administration has cut funds for in-person enrollment assistance, cut the enrollment period in half and slashed ObamaCare’s advertising budget by 90 percent. It will also shut down the website people use to sign up for coverage during open enrollment once a week on Sunday, for maintenance. 

“I am very concerned that the president’s actions have confused people, along with all of the conversation around the attempts to pass the two versions of TrumpCare we saw earlier this year,” said Sen. Maggie HassanMargaret (Maggie) HassanOvernight Health Care — Sponsored by PCMA — Trump hits federally funded clinics with new abortion restrictions Dem senators ask drug companies to list prices in ads Overnight Health Care — Sponsored by PCMA — Trump official won't OK lifetime limits on Medicaid MORE (D-N.H.). 

She hopes the bipartisan bill, if passed, could help with some of that confusion because it restores funds for advertising and in-person assistance. 

But the Trump administration’s decisions to cut advertising might already be having an impact. 

Only 31 percent of insured consumers and 12 percent of uninsured individuals know that open enrollment begins Nov. 1, according to a poll commissioned by Get America Covered, an initiative aiming to get the word out about open enrollment. 

Only 12 percent of insured consumers and 6 percent of uninsured individuals know open enrollment ends Dec. 15, the poll found. 

Another poll released Wednesday by the Kaiser Family Foundation found similar results.

Only 33 percent of all enrollees in the individual market knew open enrollment begins Nov. 1. About 30 percent of the public said they thought the individual mandate was not in effect, or didn’t know if it was. 

“I think there’s a lot of confusion, a lot of mixed messages out there, and the reduction in advertising and in-person assistance funding are certainly contributing to that,” Tolbert said. 

“What we know is that consumers need to hear this information over and over and over again. With the cuts to advertising, particularly the lack of television advertising, fewer consumers are going to hear the messages and be aware of the upcoming dates for the open enrollment period.”

The Department of Health and Human Services (HHS) is already setting expectations low. 

“It’s important to remember that Obamacare enrollment was in decline before President Trump took office,” HHS spokesman Matt Lloyd said. 

10.3 million signed up for ACA plans for 2017 and paid their first month’s premium, compared to 11.1 million in 2016 and 11.7 million in 2015. 

Under the Obama administration, HHS would release projections detailing how many people it expected to sign up for coverage the following year. 

The Trump administration did not answer questions about whether it would continue that tradition. 

But ObamaCare supporters are almost certain the numbers won’t look good. 

“They’re talking about how ObamaCare is imploding, which it is not. However, the administration is trying to make that happen,” said Lori Lodes, a former Obama official who oversaw outreach efforts under the previous administration. 

“The actions that the administration has taken this year … all of that taken together will mean fewer people will sign up. All of the recent actions by the administration that really are just going to sow additional confusion,” she said.