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]