Efforts to Undermine the Start of Open Enrollment for 2018 Healthcare Coverage on November 1
Open enrollment for individuals to purchase healthcare coverage through government exchanges begins tomorrow and runs through December 15. Both advocates and opponents of the Affordable Care Act (ACA) are anxious to see what happens with this year’s enrollment numbers in light of several steps taken by the Trump administration to undermine the ACA in recent months.
Among the actions taken by the Trump administration in 2017 has been to reduce this year’s ACA enrollment period from 90 to 45 days, and drop by 90% the funds used to advertise the ACA open enrollment period, a reduction in millions of dollars. This will result in less marketing to raise awareness of the upcoming ACA enrollment period, and fewer trained representatives provided by nonprofit organizations to help low-income families understand their health insurance options on the federal government exchange. In addition, the U. S. Department of Health and Human Services (HHS) has told staff from regional offices to refrain from participating in healthcare marketplace enrollment events as they had in previous years. And all signs point to the Centers for Medicaid and Medicare (CMS) going forward with plans to temporarily shut down Healthcare.gov for maintenance from 12 a.m. to 12 p.m. ET every Sunday during the enrollment period, except for December 10. CMS is expected to also shut down the federal exchange overnight on the first day of open enrollment tomorrow.
The reduction in funds for ACA Navigator programs is expected to hurt this year’s ACA enrollment. ACA Navigator programs provide outreach, education, and enrollment assistance to consumers eligible for coverage through the government marketplaces. Through the Navigator program, consumers are provided in-person support provided by individuals or organizations trained to provide free, unbiased help to consumers as they shop for health coverage through government marketplaces. This help was especially useful for those with low health coverage literacy and limited English proficiency. Navigators can only help consumers sign up for coverage; they cannot offer guidance in the selection of insurance plans.
CMS has funded Navigator programs in the 34 states that use the federal marketplace through a multi-year agreement that was expected to continue for the current budget year. However, in August, CMS officials announced significant reductions of more than 40% for funding for Navigators to support the open enrollment for 2018. It’s expected that these significant funding reductions will reduce the help many Navigators can provide to consumers seeking to enroll in coverage through the government exchanges.
A study by the Kaiser Family Foundation (KFF) found that most states saw funding reductions for Navigator programs ranging from 10% to 80%. Only three states received no net reduction in year-three Navigator funding.
The funding reductions were made despite the past success of these programs. The KFF study found that most programs met or exceeded their goals.
Most Navigator programs say they will continue to operate in 2018 despite the funding reductions. However, most programs report they will likely reduce their geographic service area and limit help for rural residents. Among programs whose funding was reduced, 45% of statewide programs and two-thirds of regional programs said it is somewhat or very likely they will have to limit the territory their program will serve in year three. Consumers living in rural communities may be the most affected. Most (55%) statewide Navigator programs and 72% of regional programs expect to limit services to rural residents this year.
You can view the full report from the Kaiser Family Foundation by clicking here.
The overall impact of the reduction in funding for various ACA activities and the shorter open enrollment period may be that people who need healthcare assistance the most will find it more difficult than ever to find the right insurance programs on government healthcare exchanges.
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