Most of the funding for an ACA outreach program is being cut by the administration, a move announced late Tuesday that touched off an angry response who called it another attempt to sabotage the health law.
The program, which provides money to outreach groups urging people to sign up for plans on the ACA exchanges, will get $10 million in federal funding for the 2019 open enrollment period, according to the Centers for Medicare and Medicaid Services, which oversees implementation of the ACA. That is down from $36 million in 2018 and almost $63 million in 2017.
Groups applying for funds will also be encouraged to provide enrollment assistance for the new plans that don't comply with the ACA, a further weakening of administration support for the previous era health law.
The administration argues that organizations getting the funding have often failed to reach enrollment goals. Advocates of the ACA, however, say the cuts are an attempt by the administration to destroy a program that is essential to ensuring robust sign-ups during open enrollment, which begins in November.
This decision reflects CMS' commitment to put federal dollars for the federally-facilitated Exchanges to their most cost-effective use in order to better support consumers through the enrollment process, according to CMS statements.
The decline in funding for the outreach groups known as "navigators" illustrates the administration's continuing push to roll back support of the health law after Congress failed to repeal the ACA. Other efforts include changes that will allow for the sale of health plans that don't comply with the ACA's consumer protection and benefit requirements. The administration has also asked a court to strike down parts of the ACA in an ongoing lawsuit brought by state attorneys general.
Outreach groups enrolled less than 1% of the consumers who signed up on the federal exchanges during the 2018 open enrollment period, CMS said in a statement. During 2016-17, seventeen navigators enrolled fewer than 100 people at an average cost of $5,000 per enrollee. In addition, nearly 80% of navigators failed to reach their enrollment goal.
CMS officials also said the need for navigators has waned because the exchanges have grown in visibility and become more familiar for Americans seeking health insurance.
About 12 million people signed up during the most recent open enrollment period, for coverage beginning in 2018. Enrollment has remained largely stable despite the efforts to curb the ACA. About 10.6 million of those people were signed up and paying their premiums in February 2018, compared with 10.3 million who were signed up and paying premiums during the same time last year.
CMS said money will go toward grantees such as chambers of commerce, small businesses, trade associations and faith-based organizations. Typically, the federal funds have been directed to community and state-based outreach groups.
Navigators are trained to help people signing up for health plans on the exchanges, and may assist with completing enrollment and application forms. They have sought to target minorities and young adults, a population that is essential for curbing premium hikes because they offset the costs of older and sicker consumers who buy plans.
They typically do their most work during open enrollment season, which this year begins on Nov. 1. Supporters say they are especially important because the open-enrollment season has been become shorter starting last year. The administration also cut funding during the last open enrollment for advertising by 90%, from $100 million in the 2016 open enrollment period to $10 million for 2017.