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Open Enrollment

Breaking: State-based Exchanges Break Enrollment Record

Washington DC — As reported by health care analyst Charles Gaba, the state-based exchanges have broken an all-time enrollment record despite the Trump administration’s relentless attempts to sabotage access to coverage. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“Millions of Americans rely on the Affordable Care Act for quality coverage and today’s announcement is evidence that the American people want and need coverage through the exchanges despite constant sabotage from the Trump administration. The fact that states who manage their own marketplaces saw record-breaking numbers this year while federal marketplaces saw a substantial decline is all the evidence one needs to prove that President Trump’s repeal-and-sabotage agenda is hurting millions of Americans.”

 

BREAKING: State-based exchanges collectively break all-time enrollment record!

ACA Signups // Charles Gaba // January 30, 2019

 

 

With Covered California releasing their final, official 2019 Open Enrollment Period data, and the latest updates from New York (which still has 2 days to go) and Massachusetts (which wrapped up last week), I now nearly all 2019 OEP data on hand.

I say nearly all because there are still three numbers missing:

  • Vermont has yet to release any 2019 enrollment data. This is the 3rd year in a row that they’ve been radio silent. Assuming they’re close to last year (28,763 QHP selections), they should add around 28,000 to the national total.
  • New York still has 2 days left for people to #GetCovered. I’m going to assume they’ll tack on perhaps 5,000 more people today and tomorrow.
  • The District of Columbia hasn’t posted any updates since December 11th, which means not only do they still have 2 days for people to sign up, they’re actually missing a whopping 51 days worth of enrollment data. Again, assuming they wrap up close to last year, that should mean another 1,400 or so from DC.

Between the three, I’d expect another ~34,000 QHP selections to be tacked onto the totals below.

However, even without that, the 12 state-based exchanges have collectively broken their all-time record for ACA Open Enrollment, racking up more than 3,018,000 QHP selections this season.

Here’s what that looks like visually…and the contrast between the Federal Exchange and the State-Based Exchanges is dramatic:

  • After a dramatic enrollment increase in 2015 and a lesser increase in 2016, the 39 states hosted by HC.gov have seen a gradual, steady decline each year since. They closed out the 2019 Open Enrollment Period with 1.3 million fewer people having signed up than at their peak in 2016. Perhaps 200,000 or so of this was due to Louisiana and Virginia expanding Medicaid in recent years, but that does nothing to explain the other 1.1 million drop-off, which is almost certainly due to having the HC.gov marketing & outreach budgets being slashed to the bone, the Open Enrollment Period being cut in half and so forth.
  • Meanwhile, the 12 states which operate their own full ACA exchanges (and which have their own marketing/outreach budgets) saw less-dramatic increases in 2015 & 2016…but they’ve collectively stayed virtual dead even for every year since then. In fact, when the dust settles on the 2019 Period, I expect the 12 state-based exchanges to reach around 3.05 million QHP selections, which would be 1.5% higher than last year and 1.3% higher than their collective all-time high in 2017.

Federal Open Enrollment Comes to A Close Amid Unprecedented Republican Sabotage Campaign

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.

When the Trump Administration Sabotages Open Enrollment, Americans Pay With Their Health Care

Washington, D.C. –  With one day left in open enrollment, the consequences of the Trump Administration’s decision to double down on sabotage for the 2018 open enrollment are clear and dramatic. Despite the availability of affordable, quality plans, the number of Americans purchasing coverage is significantly down. Leslie Dach, chair of Protect Our Care, issued the following statement in response:

“This year, Donald Trump pulled out all the stops and left no stone unturned when it came to sabotaging open enrollment. The Trump Administration shortened the sign-up period, slashed funding for outreach, and removed critical information on how to gain coverage from Healthcare.gov. We all know the Affordable Care Act helps millions of Americans find quality, affordable health care, protects people with pre-existing conditions, and ensures coverage when we get sick. But instead of listening to the voters who made health care the top issue during the midterm elections, Donald Trump is raging forward with his war on health care and costing millions of American families access to life-saving care. It’s shameful.”

BACKGROUND: TRUMP ADMINISTRATION 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.

Shot/Chaser: The Trump Administration Feigns Ignorance on Health Care Sabotage

Today, at an event sponsored by Axios, Health and Human Services Secretary Alex Azar feigned ignorance about why enrollment in the health care marketplaces is lower this year compared to last year. We have an idea. Don’t forget: the last day to sign up is December 15.

 

SHOT: “We don’t know why they’re at where they are now.” [Axios]

 

CHASER:

  • This year, the Trump administration slashed funding for non-profit health navigator groups, that help people shop for coverage, by nearly 75 percent.
  • For the second consecutive year, the Trump administration spent $10 million on the advertising budget to get the word out about open enrollment, down 90 percent from $100 million under the Obama administration.
  • This year, the Trump administration issued new guidance urging states to “tear down basic pillars of the Affordable Care Act,” that would make comprehensive coverage more unaffordable.
  • This year, the Trump administration made it easier for insurance companies to sell junk health insurance that can deny people coverage based on a pre-existing condition.

INVESTIGATION REVEALS: Trump Administration Tries to Rig Health Care Enrollment To Make Coverage Options Secret

Washington DC – This morning, a new Sunlight Foundation investigation revealed that the Trump Administration is sinking to new levels to sabotage the Affordable Care Act. Days before the open enrollment deadline, HHS removed information about ways to apply for coverage on HealthCare.Gov, which may cause confusion and could impede consumers ability to obtain health insurance coverage. According to Sunlight’s investigation, they are directing people to sign up for coverage through enrollment sites run by for-profit companies, and have removed the option of signing up for coverage by mail and phone. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“The Trump administration wants to make it as hard as possible for people to get the health care that they deserve and as easy as possible for the big health insurance companies to profit. Today, that means another round of health care sabotage. That sound you hear is the constant screech of a broken record, but it’s nothing in comparison to the real pain Americans are feeling from the Trump administration’s continued sabotage of our nation’s health care system. This administration’s relentless attacks on open enrollment, which include slashing the open enrollment period, dramatically cutting advertising, and instructing navigators to direct folks to junk plans, is now being punctuated by the removal of information explaining how to apply for coverage, serving no purpose other than to separate individuals from their health care coverage.”

 

In overhaul of HealthCare.gov webpage, information about ways to apply is gone

Sunlight Foundation// Rachel Bergman // December 11, 2018

A side-by-side of a previous version of the “Apply for Health Insurance” page from November 14, 2018, and a new version of the page from November 22, 2018. Snapshots captured by the Internet Archive’s Wayback Machine.

A few weeks after the start of the Open Enrollment period to sign up for Affordable Care Act (ACA) coverage, which runs from November 1 to December 15, 2018, HealthCare.gov’s “Apply for Health Insurance” webpage was altered. Information about two ways to apply is now missing and has been replaced by a new list of application options and links, including a link for “Help On Demand,” a third-party consumer assistance referral system, operated by a for-profit software company, BigWave Systems.

In today’s new report from the Web Integrity Project, we document the overhaul of the “Apply for Health Insurance” page, the portion of the ACA enrollment website that describes different ways consumers can apply for health coverage.

Previously, the page contained a table that listed five ways to apply, with links to pages that provided more information about each option: 1) online (using HealthCare.gov), 2) by phone, 3) with in-person help (from assisters), 4) through an agent or broker, and 5) by mail. Now, the page lists only four options: 1) Find and contact an agent, broker, or assister; 2) Have an agent or broker contact you; 3) Use a certified enrollment partner’s website; and 4) Use HealthCare.gov.

Two of the options — to enroll by phone and by mail — have been completely removed. These removals occurring well into the Open Enrollment period, after consumers may have already visited HealthCare.gov and decided to use one of these methods. The removals may cause confusion and could impede consumers’ ability to obtain health insurance coverage.

The third option, enabling users to get “in-person help” from assisters has been merged with the fourth option, to find an agent and broker. (Although these option were previously listed as distinct options, they both provided a link to the same page.) While the assister community is broad, and includes all individuals or organizations trained to provide free help to consumers and small businesses searching for and enrolling in health coverage, agents and brokers are part of narrower group of this community and usually receive commissions from health insurance companies for each plan they sell.

Some of the added links associated with new options may reflect policy changes at the Centers for Medicare and Medicaid Services (CMS) — the office that manages and funds HealthCare.gov. These policy changes are aimed at making it possible for consumers to bypass HealthCare.gov to find ACA coverage. The added links preceded CMS’s release of new guidance on enhanced direct enrollment, which allows websites of approved third-parties, including agents and brokers, to provide consumers with the same information and capacity to manage their coverage as is available through HealthCare.gov.

The new set of options includes third-party entities in three of the four options, listing agents and brokers twice and linking to information about using partner websites to enroll in coverage.

Specifically, a link listed as part of the new “Have an agent or broker contact you” option directs users to an “exit” webpage, warning “Once you leave HealthCare.gov, you’re subject to the privacy and security policies of the Help On Demand site, operated by BigWave Systems.” Clicking the “Go Now” button from this page directs users to the third-party website. According to CMS, the “Help on Demand” website, which is run by a for-profit, private software company, “connects consumers seeking assistance with Marketplace-registered, state-licensed agents and brokers in their area who can provide immediate assistance with Marketplace plans and enrollments.”

The page linked from the new “Use a certified enrollment partner’s website” option explains that certified partners may include online health insurance sellers, who will show you all the Marketplace coverage plans offered in your area, or insurance companies, whose websites may show you only the Marketplace plans they offer. Some certified partners let you shop for plans on their websites but require you to enroll on HealthCare.gov, and others allow you to shop, enroll, and manage your plan on their own websites, completely separate from HealthCare.gov.

Beyond including new options to use “Health On Demand” and partner websites, the order in which options appear on the page changed. The option to use HealthCare.gov — the website on which the “Apply for Health Insurance” page is hosted — is now last on the list of ways to apply. Before the change, it was listed as the first option. This change, in conjunction with options that direct consumers off of the HealthCare.gov website, demonstrates a de-emphasis by CMS of the very website it manages.

The shifts in information on the “Apply for Health Insurance” page are not a one off. This report on the overhaul comes on the heels of WIP’s recent report, describing the removal of an assister training guide for Latino outreach. Jodi Ray, who oversees an assister effort as director of Florida Covering Kids & Families at the University of South Florida, told the Washington Post about the importance of these training materials in enabling her work. “If you pull credible resources, make it less accessible, it does make our job more difficult,” said Ray. “You have to know your community, the population, the culture of who you’re trying to reach. If we’re not providing the resources to be able to do that effectively, we’re going to lose that population that needs this more than anyone.”

Indeed, the overhaul of the “Apply for Health Insurance” page and the removal of the Latino outreach training guide come amid an array of Trump administration efforts to undermine the Open Enrollment period. These efforts include cutting the advertising and promotional budget for the ACA last year and multiple budget cuts to federally-funded assister programs.

Through a de-emphasis of HealthCare.gov, the removal of information about some of the simple methods for applying for coverage under the ACA, and the addition of options directing users to insurance sellers outside of the Marketplace, the overhaul of the “Apply for Health Insurance” page reduces access to information and options for obtaining health insurance. This ultimately amplifies the many other efforts by this administration to undermine Open Enrollment and access to health coverage broadly.

More Proof: Trump Administration Targets Latinos In Its Open Enrollment Sabotage

Washington, DC – As part of its efforts to sabotage open enrollment, the Centers for Medicare and Medicaid Services removed a training guide for Latino outreach from a CMS website. This move is just one more part of the Administration’s sabotage efforts, including drastic cuts to outreach efforts and shortening the enrollment time period. Leslie Dach, Chair of Protect Our Care, issued the following statement in response:  

“From day one, Donald Trump has worked to sabotage health care for millions of Americans. Now, the Administration has targeted Latinos by deleting critical information from the HHS website that provides training for navigators as they assist Latino communities during the enrollment period. We all know open enrollment is a critical time for Americans to get the coverage they need. The Affordable Care Act is particularly important to Latinos, who are uninsured at a disproportionately high rate of 22 percent. There is no doubt in my mind that the Trump Administration is taking active steps to harm health care at the expense of the American people.”

 

BACKGROUND:

22 Percent Of Hispanic Americans Are Uninsured. The uninsured rate of Hispanic Americans is 22 percent, more than twice that of white Americans, 9 percent of whom are uninsured.

Between 2016 And 2018, The Trump Administration Has 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 2017, The Trump Administration Cut The Open Enrollment Advertising budget By 90 Percent. 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:

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.

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.

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

New Poll: Trump Administration’s Sabotage Efforts Harm Open Enrollment  

Washington DC — The Kaiser Family Foundation released its November tracking poll and found that the Trump Administration’s ongoing sabotage campaign is preventing the American people from signing up for coverage. This isn’t surprising given the Trump Administration’s repeated sabotage of the open enrollment process by cutting outreach resources and shortening the enrollment time period. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:

“The fact that people do not know they have until December 15th to sign up for coverage is another proof point in the Trump Administration’s sabotage of the Affordable Care Act. We all know open enrollment is a critical time for Americans to get the coverage they need. But Donald Trump and Republicans continue to do nothing to get the word out. We must redouble our efforts to let Americans know they only have until December 15th to sign up for coverage. In many cases, premiums are lower this year, making plans more affordable for millions of families across the nation. People who need insurance should sign up for coverage on HealthCare.gov before the December 15th deadline.”

The tracking poll showed that:

  • Only one in four Americans know the deadline to sign up for coverage during open enrollment.
  • The poll shows 77 percent of Americans said either they did not know, refused to answer, or gave the wrong date for the open enrollment deadline.
  • Only three in ten people who would buy coverage reported hearing or seeing information about how to do so in the past 30 days

 

BACKGROUND:

Between 2016 And 2018, The Trump Administration Has 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 2017, The Trump Administration Cut The Open Enrollment Advertising budget By 90 Percent. 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:

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.

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.

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.

Elections Have Consequences

400,000 Virginians Now Eligible to Enroll in Medicaid

Washington DC – Today, hundreds of thousands of Virginians between the ages of 19 and 64 who earn less than 138 percent of the federal poverty level are now able to enroll in Medicaid, with the commonwealth having succeeded in enacting Medicaid Expansion earlier this year after the 2017 election during which health care was the number one issue to voters according to exit polls.  Brad Woodhouse, executive director of Protect Our Care, issued the following in response to today’s news:

“Today, hundreds of thousands of Virginians will gain access to quality health coverage, something only made possible because voters motivated by health care turned out in droves to elect pro-health care leaders in 2017. With only five days until the midterm elections, Americans across the country are gearing up to make their outrage about the Republican war on health care known because Republicans who still stubbornly oppose Medicaid expansion — be they Scott Walker, Ron DeSantis, Mitt Romney or Donald Trump — are on the wrong side health care, the wrong side of voters, and the wrong side of history.”  

MEDICAID EXPANSION IS A DEFINING ISSUE IN GOVERNOR’S RACES ACROSS THE COUNTRY

In Georgia, Democratic Candidate Stacy Abrams Has Said The First Thing She Would Do Is Expand Medicaid. “Democratic candidate Stacey Abrams has said the first thing she would do as governor is expand Medicaid. That’s the decision each state can make to give more low-income people access to health care. States receive federal funding for it, though they, too, have to pay into the program. ‘And you’ll hear me talk about this ad nauseam because it’s the only answer to Georgia’s challenges,’ Abrams said at a health care policy press conference Monday. ‘We have an uncompensated care rate of $1.7 billion.’…Republican Gov. Nathan Deal has refused to expand the program in Georgia, and Republican candidate Brian Kemp said he wouldn’t expand it either. ‘Government programs that aren’t working now are not a reason to give them more money,’ Kemp said at an event last week. Kemp said, instead, he favors opening up the private sector market to more competition to lower health care costs.” [WABE, 9/12/18]

In Florida, Andrew Gillum is running on Medicaid Expansion, with polling showing Floridians want to expand Medicaid. “According to new data from the left-leaning think tank Data for Progress, an estimated 65 percent of Florida voters support expanding Medicaid across the state — and, amazingly, voters in every legislative or congressional district from the Keys all the way up to the Panhandle support the idea.” [Miami New Times, 5/25/18]

In Ohio, Cordray Blasts DeWine, Who Flip-Flopped on Medicaid Expansion because it is so Popular. “Cordray also dinged DeWine on Ohio’s Medicaid expansion, which provides health coverage to nearly 700,000 Ohioans. Republican Gov. John Kasich has ‘done some things that are very good for Ohio,’ Cordray said. ‘He had real courage on the Medicaid expansion, bringing that to Ohio and fighting the naysayers in his own party who said, ‘Gee, that’s part of Obamacare.’ And my opponent was part of those naysayers.’ DeWine now says he’ll keep the expansion. But Eck didn’t answer a question asking why, if he favored it, DeWine repeatedly sued to kill the law that made it possible.” [Columbus Dispatch, 9/20/18]

In Wisconsin, Democratic Challenger Tony Evers Targets Scott Walker For Not Taking Federal Medicaid Expansion. “Evers made health care the focus of his only television ad to date, faulting Walker for not taking the federal Medicaid expansion and pointing out that the cost of an average health insurance plan sold on the private market this year in Wisconsin was more expensive than in Minnesota. Walker argues the ad is misleading and health insurance costs will decrease in Wisconsin once a recently approved reinsurance program takes effect.” [Minneapolis Star Tribune, 9/7/18]

In Michigan, Candidates Gretchen Whitmer (D) and Bill Schuette (R) Spar Over Medicaid Expansion. “As attorney general, Schuette joined at least nine lawsuits fighting the Affordable Care Act. In a 2017 fundraising mailer, he said he opposed the law, ‘including the ‘free’ federal Medicaid dollars from Obama that leave Michigan taxpayers on the hook for more!’ ‘He has been the chief advocate against Healthy Michigan in our state ever since we started the bipartisan negotiations on it,” Whitmer told The Detroit News. ‘The biggest threat to health care in Michigan is Bill Schuette.’ But the Medicaid expansion program is threatened by declining federal aid, Schuette notes. The federal government fully funded the Medicaid expansion program the first three years, but the state began paying a share in 2017 and will be required to cover 10 percent of the costs by 2020. By then, it’s estimated to cost the state roughly $380 million a year.” [Detroit News, 9/18/19]

In Tennessee, Karl Dean is Running on Medicaid Expansion, with Polls Showing Voters Support it Strongly. “The poll, conducted by Mason-Dixon Polling & Research in April, showed 63 percent support Medicaid expansion with the use of federal funds to 21 percent against and 16 percent undecided.” [Nashville Tennessean, 5/7/18]

In Idaho, Democratic Candidate Paulette Jordan is a Supporter of Prop 2 (Medicaid Expansion). Her opponent, Lt. Gov. Brad Little has declined to say whether he will vote for the initiative but said if elected governor, he would respect the will of the voters if they pass Medicaid expansion. [KTVB, 10/29/18]

In Alabama, Democratic Challenger Walt Maddox Is Running On Medicaid Expansion. “The Democratic nominee began the tour in Tuscaloosa where he is mayor. Describing himself as the only candidate in the race talking about the state’s “big problems”, Maddox is running on a platform of establishing a state lottery to fund education programs and expanding Medicaid. Standing with his wife, Stephanie and his two children, Maddox said the race is about ensuring the state’s children have opportunities.” [Associated Press, 9/17/18

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]

CMS Report Confirms GOP Sabotage

Washington, D.C.  – Today, the Centers for Medicare and Medicaid Services released a trends report about last year’s open enrollment period, which saw decreased enrollment and rising premiums. Protect Our Care Executive Director Brad Woodhouse released the following statement in response:

“Today’s report confirms that Republican sabotage is directly responsible for rising premiums and fewer Americans obtaining health insurance, outcomes which were entirely avoidable. From the day he took office Donald Trump has worked with Congressional Republicans to sabotage the Affordable Care Act, and nowhere was this more evident than last year’s open enrollment period. The Administration cut in half the number of days people could sign up for coverage; reduced the outreach budget by ninety percent; and used funding to boost open enrollment to launch a propaganda campaign against the ACA. All told, these actions reduced enrollment by more than one million people – and as we look toward next year’s open enrollment period, the Trump Administration has already dramatically cut in-person assistance to help people sign up for 2018 health coverage, and we can expect more of the same. Unfortunately, it is the American people who will once again be left to suffer.”

BACKGROUND:

  • In April, the Trump Administration cut the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.
  • In July, the Trump Administration used funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.
  • In August, the Administration cut 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.
  • In September, the Administration ordered 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.”
  • In October, the Trump Administration dramatically cut in-person assistance to help people sign up for 2018 health coverage.
  • Last week, it was reported that the Trump Administration proposed further massive cuts for health insurance navigators.