Groups fear Trump funding cuts will lower ObamaCare enrollment

Groups fear Trump funding cuts will lower ObamaCare enrollment
© Getty Images

Groups that for years have helped people sign up for ObamaCare say the White House's cuts to their funding will almost certainly lower enrollment in the insurance exchanges this year.

Some of the groups, known as navigators, say they’re worried they’ll have to permanently cut back on staff, as well as education and outreach about the health-care law ahead of an open enrollment period beginning Nov. 1.

“The ultimate goal is to try to get as many folks signed up onto it as we can who are eligible,” said Kathie Hiers, CEO of AIDS Alabama, which has received federal grants in the past to help sign people up for the exchanges.


“Anything like this, when you take away the marketing, and you take away the personnel, that's going to decrease enrollment," she said. "It's hard for me to say exactly how much, but it will decrease.”

The move to slash funding comes after Republicans failed to approve legislation repealing ObamaCare. Supporters worry the Trump administration now may be deliberately trying it undermine it.

The administration announced last week it would spend just $10 million on advertising for enrollment season, a 90 percent reduction from last year.

The groups helping to enroll people in ObamaCare learned their three-year federal grant would be cut 41 percent, from $62.5 million to $36.8 million.

“I was completely caught off guard,” said Jodi Ray, director of Florida Covering Kids and Families, which is affiliated with the University of South Florida. “I was stunned.”

As of Thursday, most organizations haven’t received any timeline for when they’ll know how much grant money they’ll be awarded, which has left them in limbo. One group said they were told they might learn of their funding by the end of the month.

A Department of Health and Human Services (HHS) spokeswoman didn’t offer a specific timetable, writing in an email that the “information is forthcoming.”

The Trump administration defended the cuts by arguing there had been “diminishing returns” from ObamaCare spending. Navigators only signed up a sliver of total enrollees, according to HHS.

“Judging effectiveness by the amount of money spent and not the results achieved is irresponsible and unhelpful to the American people,” HHS spokeswoman Caitlin Oakley said in a statement emailed to reporters after the announcement.

She called the program “ineffective” and said navigators will be funded going forward based on their performance.”

The groups say their work is more than just enrollment. They also work to educate people on ObamaCare about their exchanges.

In Alaska, for example, the state’s sole insurer had proposed a more than 20 percent decrease in premiums. Jessie Menkens — the Alaska Primary Care Association’s navigator program coordinator — worries the word won’t get out if their grant money is reduced.

“Now is the time,” she said, “to increase participation in our marketplace and help educate Alaskans about the fact that they have this opportunity now and that costs are going down.

“And that’s where we step in, and it’s really critical that we have the ability to do our work. We have a lot of work to do.”

Enroll Michigan’s statewide navigator network participated in more than 2,000 events last year where attendees could learn about the health-care law and get answers to their individual questions.

A drop in funding will “definitely damper” their ability to do similar outreach this year, said Dizzy Warren, Enroll Michigan’s executive director.

Some areas could see less enrollment in the exchanges, she said. And for some consumers, it could cause the quality of their coverage to decline, as enrollees may not be able to find the health insurance that works best for them on their own.

Navigators will also face new challenges with less funding.

There’s a shortened enrollment period to contend with, as the Trump administration cut this window in half, to 45 days. And the GOP’s attempt to repeal and replace ObamaCare has lead to confusion, with some consumers wondering if the health-care law even still exists.

Navigators had anticipated the federal government decreasing its own advertising efforts and already were planning to try and make up for the lack of robust marketing coming from the administration.

“You put that together with the shortened open enrollment period and then an administration that has put out messages that to many people say that there is no more individual mandate, that the law is dead, that there is no penalty — that pattern of misinformation then helps to curtail enrollment even more,” said Shelli Quenga, director of programs for the Palmetto Project, a South Carolina nonprofit that gets navigator grants.

As navigator groups wait for their funding awards, some are scaling back operations.

For instance, at the Palmetto Project, Quenga decided to lay off two people, told four people who were supposed to start work on Tuesday not to, transitioned seven full-time employees to part-time and cut salaries for about five employees by one-fifth, including herself.

She hopes it’s a temporary move, but there’s no guarantee the changes aren’t final.