Washington, D.C. – Following the devastating ruling from Judge Reed O’Connor to overturn the Affordable Care Act (ACA) during the final hours of open enrollment – one of the busiest times for sign-ups – we learned that a lot fewer people signed up for coverage through the federal exchange marketplace. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“Americans want and need the quality, affordable coverage provided by the Affordable Care Act. Open Enrollment sign-ups would be dramatically higher if not for the unprecedented Republican sabotage campaign, which included slashing advertising by 90 percent, dramatically cutting navigator assistance, and shortening the enrollment time period. Democrats ran on health care and were able to take back the House, and in the Majority these Democrats will work to fully fund open enrollment and end this sabotage, ensuring that Americans of all backgrounds are able to obtain the coverage they need. Will Republicans ever learn to do the same?”

BACKGROUND: THE TRUMP ADMINISTRATION AND REPUBLICANS DOUBLED DOWN ON OPEN ENROLLMENT SABOTAGE IN 2018

The Trump Administration Removed Information On Applying For Coverage From HealthCare.gov. The Trump Administration overhauled the “Apply for Health Insurance” section of HealthCare.gov, removing the options of signing up for coverage via mail and phone and directing people to sign up for coverage through enrollment sites run by private companies.

Between 2016 And 2018, The Trump Administration Cut Funding For Groups That Help People Sign Up For Coverage By 84 Percent. After cutting funding for navigator groups that help people sign up for coverage from $63 million in 2016 to $36 million in 2017, the Trump Administration made yet another round of cuts in 2018, leaving just $10 million in funding for health navigator groups. Since 2016, Trump has cut navigator funding by 84 percent.

Health Navigators, Like Jodi Ray At The University Of South Florida, Say Cuts To Navigator Programs Prevent Them From Adequately Letting People Know That Open Enrollment Is Happening. Ray said, “We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening.”

This Year, 800 Counties Served By The Federal Marketplace Are Operating Without Any Federally-Funded Navigators. This is more than six times as many counties served by the federal marketplace that operated without federally funded navigators in 2016, when 127 counties lacked such a navigator.  

The Trump Administration Wants Navigator Groups To Push Consumers To Sign Up For Junk Coverage That Is Exempt From Covering Prescription Drugs And Hospitalization Instead Of Comprehensive Plans. The Administration announced in July that it would encourage navigator groups to use their remaining funding to push consumers to sign up for junk health plans, which cover few benefits and notorious for the fraud they attract.

In December 2017, The Trump Administration Repealed The Requirement That Most People Have Insurance Despite The CBO Estimate That Doing So Would Increase The Number Of Uninsured By 13 Million. The Republican tax bill passed last December was estimated by the nonpartisan Congressional Budget Office to increase the number of uninsured by 13 million in 2027.

All Of This Comes After The Trump Administration Cut The Open Enrollment Advertising Budget By 90 Percent in 2017. As ABC News summarized, “In 2016, the Centers for Medicare & Medicaid Services spent $100 million on Obamacare advertising and outreach, but for [2017]’s open enrollment period, CMS plans on spending $10 million.” CMS chose not to increase the budget for 2019.

A full timeline of the Trump Administration’s crusade to sabotage open enrollment is below:

December 2018

  • Sunlight Foundation investigation finds that Trump Administration removed information about ways to apply for coverage on HealthCare.Gov and is directing people to sign up for coverage through enrollment sites run by for-profit companies.

October 2018

  • The Trump Administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions, a move expected to worsen ACA risk pools.
  • Trump Administration announces scheduled maintenance on the open enrollment website, preventing people from signing up for coverage on Sundays from 12:00 AM – 12:00 PM.

September 2018

  • Centers for Medicare and Medicaid Services removes a training guide for Latino outreach from a CMS website just over a month before the beginning of open enrollment. Latinos are at a disproportionately high risk of being uninsured compared to white non-hispanic Americans.

August 2018

  • Trump Administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • Trump Administration slashes funding for non-profit health navigator groups that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.

July 2018

  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

December 2017

  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act  by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

October 2017

  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered. Emails obtained by Democracy Forward reveal that the administration chose to cut outreach despite having been warned that over 100,000 fewer people would enroll in coverage.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.

January 2017

  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000.