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Navigators Archives — Protect Our Care

House Energy & Commerce Committee Continues to Deliver On Their Promise to Americans With More Legislation Designed to Lower Costs, Improve Care, and End Trump Administration’s Sabotage

Democrats, Responding to the Mandate from Voters in November, Introduce Bills to Reverse the Trump Administration’s Harmful Cuts to the Navigator Program, Provide States More Funding to Establish State-Based Marketplaces, and Provide Funding for States to Set Up Their Own Reinsurance Programs

Washington, DC — Today, the Subcommittee on Health of the Committee on Energy and Commerce held a hearing announcing a second round of bills that are aimed at lowering costs, increasing access to care, and blocking the Trump administration’s sabotage of our health care system. The first round of bills considered by the committee would halt the administration’s harmful waivers, roll back junk plans that undermine protections for people with pre-existing conditions and provide insufficient coverage, and restore funding for open enrollment that has been slashed by President Trump in an act of deliberate sabotage.

This set of bills would reverse the Trump administration’s harmful cuts to the navigator program that denied people access to fair and impartial information on enrollment and financial assistance options; provide states more funding to establish state-based marketplaces giving states the ability to tailor the program to meet the particular needs of their residents; and provide funding for states to set up their own reinsurance programs that make health care more affordable for everyone throughout the individual market including those with serious medical conditions.

“Last November, voters rejected the Trump administration and their GOP allies’ repeal and sabotage agenda and scores of Republicans in Congress were shown the door as a result,” said Brad Woodhouse, executive director of Protect Our Care. “Democrats are continuing to turn the page on the willful sabotage by Republicans by doing what the American people asked of them – make health care more affordable and accessible to all. With this set of bills, Democrats are continuing to show us they’re serious about delivering on their promise to voters to lower costs and improve care for all Americans.”

Background

The Health Subcommittee of the Committee on Energy and Commerce will consider the following bills:

H.R. 1425, the “State Health Care Premium Reduction Act” would provide $10 billion annually to states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs for individuals enrolled in qualified health plans. The bill also requires the Centers for Medicare and Medicaid Services (CMS) to establish and implement a reinsurance program in states that do not apply for federal funding under the bill.

H.R.1386, the “Expand Navigators’ Resources For Outreach, Learning, And Longevity (ENROLL) Act” would provide $100 million annually for the Federally-facilitated Marketplace (FFM) navigator program. The bill would reinstate the requirement that there be at least two navigator entities in each state and would require the Department of Health and Human Services (HHS) to ensure that navigator grants are awarded to entities with demonstrated capacity to carry out the duties specified in the Affordable Care Act. The bill would also prohibit HHS from considering whether a navigator entity has demonstrated how it will provide information to individuals relating to association health plans or short-term, limited-duration insurance plans.

H.R.1385, the “State Allowance For A Variety Of Exchanges (SAVE) Act” would provide states with $200 million in federal funds to establish state-based Marketplaces. Under current law, federal funds are no longer available for states to set up state-based Marketplaces.  

Trump Administration Sabotages Open Enrollment, Pushes Junk Plans, Attacks Assistance for Navigators Yet Again

Washington, D.C. – This afternoon, the Trump Administration announced that it was slashing navigator funding designed to designed to help Americans obtain coverage by 84 percent and pushing enrollment for junk plans that charge people more money for less care and can deny coverage to people with pre-existing conditions. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“Last year, the Trump Administration cut the open enrollment period in half and slashed advertising by ninety percent. Now the Administration is once again doubling down on their sabotage of American health care by coupling further drastic cuts to the individuals who help Americans enroll with a cynical attempt to push Americans into junk plans which can deny coverage to those with pre-existing conditions. Yet again the Trump Administration is taking active steps to harm health care, and yet again it is the American people who will be left to suffer.”

BACKGROUND:

Junk Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Trump Administration Slashes Grants To Help Americans Get Affordable Care Act Coverage. “The Trump administration has distributed $10 million in grants to 39 organizations that help people enroll in Obamacare, a drop from the 90 organizations that received the awards last year when funding was nearly three times as high. The Trump administration slashed the budget for navigators from $100 million during the final open enrollment of former President Barack Obama’s term to $36 million, and slashed it even further to $10 million this year. Democrats have called the move another instance of ‘sabotage’ against the healthcare law.” [Washington Examiner, 9/12/10]

During The First Open Enrollment Period, 10.6 Million Americans Were Assisted By Navigators. “More than 4,400 Assister Programs, employing more than 28,000 full-time-equivalent staff and volunteers, helped an estimated 10.6 million people during the first Open Enrollment period.” [Kaiser Family Foundation, 7/15/14]

For Months, The Groups That Help People Sign Up For Marketplace Coverage Have Been In Limbo. “Local groups that help people sign up for ObamaCare and Medicaid have yet to hear from the Trump administration about their annual federal funding, leaving many in limbo and fearing the grants could be too small or might not come at all…The organizations typically hear from the federal government in April or early May with information about how much money will be available for grants, when key deadlines are and the expected award date. But several navigators contacted by The Hill said they have received no information from the Centers for Medicare & Medicaid Services..When asked about the navigator grants, a spokesperson for the Department of Health and Human Services (HHS) wrote in an email that HHS did not have any details to share at this time.” [The Hill, 6/20/18]

  • Dan Derksen, Doctor Who Oversees Navigator Program At University Of Arizona: “At a time when people have more questions, it’s very likely there will be fewer people to help them in person.” [USA Today, 6/21/18]
  • Last Year’s Cuts Led University Of Florida Navigator Program To Cut Staff. “Jodi Ray, director of Florida Covering Kids & Families navigator group at the University of South Florida, said her organization is bracing for changes. Last year’s cuts forced the Florida group to trim the number of employed navigators. She worries that further cuts and program changes could harm the state’s vulnerable residents who rely on the organization’s services.” [USA Today, 6/21/18]
  • Karen Egozi, CEO Of The Epilepsy Foundation Of Florida: We’re In The Dark. “We really haven’t gotten any update or any deadline to submit applications or any knowledge at all about what the future is going to bring.” [The Hill, 6/20/18]
  • Catherine Edwards, Executive Director For The Missouri Association Of Area Agencies On Aging: Administration Has No Incentive To Work With Community Groups. “We know this administration is not friendly to the ACA, and so they have no incentive to involve community-based groups in enrolling people.” [The Hill, 6/20/18]
  • Shelli Quenga, Director Of Programs For South Carolina-Based Palmetto Project: Restricting Support Is Bad For Consumers. “It’s very unfortunate for the consumer…We know that consumers still need in-person assistance — and especially consumers who are not native English speakers, consumers who are living just above the poverty line who don’t have a lot of experience with making big financial decisions like this that also have long-term implications to their financial future for themselves and their family members.” [The Hill, 6/20/18]
  • Cutting Funds To Navigator Groups Means They Must Significantly Cut Back On Outreach. “‘We have no expectation of any federal money being available to us,’ said Donna Friedsam, the director of Covering Wisconsin, a navigator program. Her organization received a 42 percent reduction last year because of the funding changes. It previously offered enrollment services in 23 counties, but had to scale down to 12.” [The Hill, 6/20/18]
  • Trump Administration Considering Cutting Funding For Health Care Navigator Groups. “The Trump administration is considering cutting funding for ObamaCare outreach groups that help people enroll in coverage, sources say. An initial proposal by the administration would have cut the funding for the groups, known as “navigators,” from $36 million last year to $10 million this year. Sources say that proposal now could be walked back, and it is possible funding could remain the same as last year, but it is unclear where the final number will end up.” [The Hill, 6/29/18]
  • Jodi Ray, Director Of Florida Covering Kids And Families: “Less Resources Means We Have Less Boots On The Ground To Provide That Enrollment Assistance.” [The Hill, 6/29/18]

“This is How Health Care Disparities Are Exacerbated”: Trump Administration Slashes Funds To Navigators That Help People Purchase Health Care

On Tuesday, the Trump Administration escalated its war on Americans’ health care by announcing it would be slashing funding for navigators, who assist people in finding quality, affordable coverage, and directing these navigators to steer people to junk plans, which don’t have to provide consumer protections like those for pre-existing conditions.

Here’s what their decision means, and how Americans will be harmed by the Administration’s actions:

New York Times: Navigator Cuts Are Next Step In An “Escalating Attack” On The Affordable Care Act. “The Trump administration announced on Tuesday that it was slashing grants to nonprofit organizations that help people obtain health insurance under the Affordable Care Act, the latest step in an escalating attack on the law that threatens to destabilize its insurance markets.” [New York Times, 7/10/18]

HHS Slashes Funding Available For Groups That Help People Sign Up For Marketplace Coverage By $26 Million.”A total of just $10 million will be available nationwide for the next enrollment season — down from $36 million for this year, and $63 million for last year…In addition to slashing navigators’ funding, CMS is also pushing navigators to sign people up for the non-ACA options the Trump administration has expanded — association health plans and cheaper, skimpier short-term policies.” [Axios, 7/11/18]

We Have Already Seen How Much Of An Impact These Cuts Have. “Last year’s cut forced navigators to lay off staff, cancel events, and, in some cases, cease operations altogether. This new cut will leave navigators with just a fraction of the money they had available for the open enrollment periods that occurred during President Barack Obama’s administration ― in all likelihood hampering their ability to help consumers through the complicated process of choosing a health insurance policy and applying for financial assistance.” [Huffington Post, 7/10/18]

Trump Administration Claims Nonprofit Navigator Groups Do Worse Job Helping People Find Coverage Than Insurance Agents And Commercial Brokers. “Trump administration officials said the insurance counselors, known as navigators, did not enroll enough people to justify more spending. Insurance agents and brokers do much better, they said.” [New York Times, 7/10/18]

Administration Fundamentally Shifts Mission Of Navigator Groups, Instructing Them To Encourage People To Sign Up For Junk Plans That Are Exempt From Key Consumer Protections. “They will, for the first time, help people enroll in health insurance plans that do not comply with the consumer protection standards and other requirements of the Affordable Care Act. Since they began work in 2013, navigators have helped people enroll in health plans that comply with the Affordable Care Act. Now the Trump administration says they should also inform consumers of other options, like ‘association health plans’ and short-term, limited-duration insurance. Such plans do not have to provide the standard health benefits like preventive services, maternity care or prescription drug coverage, but administration officials say they will also be more affordable to consumers.” [New York Times, 7/10/18]

New York Magazine: “The Trump White House Has Been Busy Separating Migrant Families And Plotting The Demise Of Roe V. Wade In Recent Weeks, But Don’t Worry: They Haven’t Forgotten About Their Quest To Make It Harder For Americans To Obtain Adequate Health Insurance.” “But the administration isn’t just making it more difficult for people to enroll in Obamacare. Going forward, the administration wants navigators to steer clients into skimpier health coverage. While nonprofits operating under the navigator program were previously forbidden from recommending particular health plans, now groups that apply for the grants will be expected to encourage people to buy association health plans or short-term insurance plans.” [New York Magazine, 7/11/18]

Navigator Cuts Will Do More Than Just Suppress ACA Enrollment, They Will Likely Also Reduce Enrollment In Medicaid And CHIP. “Consumers who use navigators frequently end up enrolling in Medicaid, the Children’s Health Insurance Program or other special programs ― or simply enrolling on their own, at home, after long consultation with navigators. As a result, they don’t show up as enrolling in the private marketplace plans, which is the metric CMS is using to judge navigator performance. Navigators also target people with special needs, including those with complicated medical or financial situations that make eligibility for federal programs confusing. These are precisely the sorts of people who might not respond to routine advertising or find the help they need through commercial brokers.” [Huffington Post, 7/10/18]

NAVIGATOR GROUP LEADERS WARN THAT CUTS WILL HURT UNDERSERVED POPULATIONS

Fred Ammons, Supervises Insure Georgia Navigator Group: This Means Less Help To Underserved Populations. “This is a huge cut to navigator programs across the country. It will virtually eliminate face-to-face in-person assistance. It means less help, much less help, to underserved, hard-to-reach populations, people who live in rural areas or have low literacy or don’t speak English as their primary language.” [New York Times, 7/10/18]

Jodi Ray, Project Director For Florida Covering Kids And Families: We Will Be Put in Awful Position Of Pitting Populations Against Each Other. “This is pretty terrible, We will be put in the awful position of pitting populations that need assistance against each other, in order to prioritize how we can use the resources. This also does not take into account all the kinds of assistance navigators provide all year, such as helping with complex cases and issues and filing appeals. Florida will definitely be hit hard by this.” [Huffington Post, 7/10/18]

  • Ray: “This Is How Health Care Disparities Are Exacerbated.” [Kaiser Health News, 7/12/18]

Catherine Edwards, Executive Director Of Missouri Association Of Area Agencies On Aging: Administration Is “Strangling” Navigator Program. “They’re just strangling the program…They couldn’t kill the program in Congress, so they are cutting the money.” [Washington Post, 7/10/18]

William Hoagland, Bipartisan Policy Center Senior Vice President: “It Does Send A Signal Of Course That The Administration Is Not Promoting Enrollment.” “Combined with other recent actions by the Trump administration, the decision sets a negative tone, Hoagland said. ‘It does send a signal of course that the administration is not promoting enrollment,’ he said.” [Kaiser Health News, 7/12/18]

Elizabeth Hagen, Senior Health Consultant: Shifting Focus To Junk Plans Will Lead Consumers To Plans That Don’t Reflect THeir Needs. “CMS now wants the navigators to promote these policies in addition to steering people toward ACA-compliant plans and Medicaid. This adds to the concern about the lack of navigator funding. The availability of such new types of coverage will increase consumer demand for specially trained navigators, said Elizabeth Hagan, a senior consultant with Transform Health, a consulting firm. She said the problem with reducing consumer assistance is not so much that fewer people will buy coverage but that people will buy policies that don’t fit their needs.”  [Kaiser Health News, 7/12/18]

Mark Van Arnam, Director of North Carolina Navigator Consortium: Cuts Will Be Devastating To People Who Need Assistance To Find Coverage. “They are the public face of the Affordable Care Act in North Carolina for legions of residents stumped by the complexities of health insurance. But next year, ACA navigators — the trained instructors who explain health benefits and help people enroll — will be harder to find as a result of federal funding cuts. The Trump administration announced Tuesday it would could nationwide funding for navigators by 72 percent, from $36 million to $10 million. In North Carolina, which has consistently had the nation’s highest enrollments, the navigator budget will be cut by 85 percent — from $3.4 million to $500,000. ‘These are significant cuts,’ said Mark Van Arnam, director of the N.C. Navigator Consortium. ‘There’s a large portion of the population that we talk to that doesn’t understand the ACA and needs assistance.’” [News & Observer, 7/12/18]

Trump Administration Pushes Junk Plans, Cuts Enrollment Assistance for Navigators

Washington, D.C. – Following the announcement by the Centers for Medicare and Medicaid Services that the Trump Administration is slashing navigator funding and pushing enrollment for junk plans that charge people more money for less care, Leslie Dach, campaign chair for Protect Our Care, issued the following statement:

“After keeping one million Americans from gaining coverage by cutting last year’s open enrollment period in half and slashing advertising for affordable plans by ninety percent, the Trump Administration is once again taking quality, affordable health care away from people who need it through its latest act of sabotage. Defunding the navigator program and forcing the navigators who are left to push junk plans on the American people is a shocking and cynical move, even by this Administration’s standards.”

BACKGROUND:

Breaking: Trump Administration Slashes Grants To Help Americans Get Affordable Care Act Coverage. The Trump administration is eliminating most of the funding for grass-roots groups that help Americans get Affordable Care Act insurance and will for the first time urge the groups to promote health plans that bypass the law’s consumer protections and required benefits. The reduction, the second round of cuts that began a summer ago, will shrink the federal money devoted to groups known as navigators from $36.8 million to $10 million for the enrollment period that starts in November.” [The Washington Post, 7/10/2018].

During The First Open Enrollment Period, 10.6 Million Americans Were Assisted By Navigators. “More than 4,400 Assister Programs, employing more than 28,000 full-time-equivalent staff and volunteers, helped an estimated 10.6 million people during the first Open Enrollment period.” [Kaiser Family Foundation, 7/15/14]

For Months, The Groups That Help People Sign Up For Marketplace Coverage Have Been In Limbo. “Local groups that help people sign up for ObamaCare and Medicaid have yet to hear from the Trump administration about their annual federal funding, leaving many in limbo and fearing the grants could be too small or might not come at all…The organizations typically hear from the federal government in April or early May with information about how much money will be available for grants, when key deadlines are and the expected award date. But several navigators contacted by The Hill said they have received no information from the Centers for Medicare & Medicaid Services..When asked about the navigator grants, a spokesperson for the Department of Health and Human Services (HHS) wrote in an email that HHS did not have any details to share at this time.” [The Hill, 6/20/18]

  • Dan Derksen, Doctor Who Oversees Navigator Program At University Of Arizona: “At a time when people have more questions, it’s very likely there will be fewer people to help them in person.” [USA Today, 6/21/18]
  • Last Year’s Cuts Led University Of Florida Navigator Program To Cut Staff. “Jodi Ray, director of Florida Covering Kids & Families navigator group at the University of South Florida, said her organization is bracing for changes. Last year’s cuts forced the Florida group to trim the number of employed navigators. She worries that further cuts and program changes could harm the state’s vulnerable residents who rely on the organization’s services.” [USA Today, 6/21/18]
  • Karen Egozi, CEO Of The Epilepsy Foundation Of Florida: We’re In The Dark. “We really haven’t gotten any update or any deadline to submit applications or any knowledge at all about what the future is going to bring.” [The Hill, 6/20/18]
  • Catherine Edwards, Executive Director For The Missouri Association Of Area Agencies On Aging: Administration Has No Incentive To Work With Community Groups. “We know this administration is not friendly to the ACA, and so they have no incentive to involve community-based groups in enrolling people.” [The Hill, 6/20/18]
  • Shelli Quenga, Director Of Programs For South Carolina-Based Palmetto Project: Restricting Support Is Bad For Consumers. “It’s very unfortunate for the consumer…We know that consumers still need in-person assistance — and especially consumers who are not native English speakers, consumers who are living just above the poverty line who don’t have a lot of experience with making big financial decisions like this that also have long-term implications to their financial future for themselves and their family members.” [The Hill, 6/20/18]
  • Cutting Funds To Navigator Groups Means They Must Significantly Cut Back On Outreach. “‘We have no expectation of any federal money being available to us,’ said Donna Friedsam, the director of Covering Wisconsin, a navigator program. Her organization received a 42 percent reduction last year because of the funding changes. It previously offered enrollment services in 23 counties, but had to scale down to 12.” [The Hill, 6/20/18]
  • Trump Administration Considering Cutting Funding For Health Care Navigator Groups. “The Trump administration is considering cutting funding for ObamaCare outreach groups that help people enroll in coverage, sources say. An initial proposal by the administration would have cut the funding for the groups, known as “navigators,” from $36 million last year to $10 million this year. Sources say that proposal now could be walked back, and it is possible funding could remain the same as last year, but it is unclear where the final number will end up.” [The Hill, 6/29/18]
  • Jodi Ray, Director Of Florida Covering Kids And Families: “Less Resources Means We Have Less Boots On The Ground To Provide That Enrollment Assistance.” [The Hill, 6/29/18]