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.
Since Republican campaigns to kill Obamacare failed in Congress last year, the Trump administration has been taking every opportunity to sabotage the Affordable Care Act. Last fall President Trump signed an executive order expanding access to association health plans and short-term limited-duration insurance. Administration officials tout these plans as more affordable, but they’re cheaper because they don’t have to meet the ACA’s requirements for decent health plans, like including maternity care and prescription drug coverage, and charging the same rate for people with preexisting conditions. Compared to the congressional fight, this boring bureaucratic maneuver received little attention, though it could still destroy Obamacare.
On Thursday the Centers for Medicare and Medicaid Services (CMS) announced the latest effort to send ACA markets into the proverbial death spiral. CMS is slashing federal money for nonprofit organizations that help people sign up for health insurance under the ACA from $36.8 million to $10 million for the enrollment period that starts in November. This is the second round of cuts, after CMS reduced funding for navigators by 41 percent, from $62.5 million, last August, and also cut the budget for Obamacare outreach and advertising by 90 percent.
CMS said the cuts are warranted because Americans have grown more aware of the marketplace, and navigators enrolled fewer than one percent of the 12 million Americans who signed up for coverage under Obamacare this year.
But navigators say this understates their accomplishments. Fred Ammons, who supervises the Insure Georgia navigator organization, told the New York Times that the move will “virtually eliminate” in-person assistance for complicated Obamacare sign ups. “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,” he said.
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.
In its announcement, CMS said the private sector is more cost-effective, so people looking for health coverage should be encouraged to go to insurance agents and brokers (who may receive a commission, unlike navigators). “It’s time for the navigator program to evolve, which is why we are announcing a new direction for the program today,” said CMS administrator Seema Verma.
But Senator Ron Wyden, the ranking Democrat on the Senate Finance Committee, said encouraging navigators to promote plans that don’t comply with the ACA is “federally funded fraud: Paying groups to sell unsuspecting Americans on junk plans that allow insurance companies to deny care on a whim and charge whatever they want is nothing but a scam.”
Every action the Trump administration has taken on Obamacare suggests that’s their goal.