Health care advisers worried by silence

With no word on budget, ‘navigators’ unable to plan for next sign-up period

A year after steep cuts to a key Affordable Care Act outreach program, the Trump administration has remained quiet on how much it will fund nonprofit and grass-roots groups that help people sign up for health insurance.

The federal navigator program funds groups that help people sign up for health insurance on the “Obamacare” federal and state insurance exchanges or assist low-income adult and children sign up for Medicaid coverage.

Navigator groups located in federal exchange states are funded through September but have no idea how much money will be available beyond then. The six-week open enrollment period that allow consumers to choose a plan for the upcoming year begins Nov. 1.

In past years, the Department of Health and Human Services announced funding opportunities in April and required navigator groups to apply for grants by mid-June. That allotted HHS staff enough time to review applications and award grants before open enrollment begins.

“It’s definitely late in the year for this,” said Karen Pollitz, a senior fellow at Kaiser Family Foundation. “When you do the math, we’re running out of days.”

The Trump administration, which has been critical of the efficiency of these groups, has reshaped the Obama-era program to operate with limited resources, according to a HHS draft rule.

Under new HHS regulations that took effect June 18, navigator groups would no longer need to be located in the states they serve. The new regulations also eliminate a requirement that at least one navigator group in a community be a consumer-focused nonprofit.

The Trump administration has pursued other changes to President Obama’s health care law. A new Labor Department rule unveiled this week allows small businesses and self-employed individuals to band together and buy potentially less expensive “association” plans that don’t carry all the benefits required by the health law.

President Donald Trump also is expected to expand the use of short-term health insurance plans that are often less expensive but don’t have the same consumer protections as exchange plans.

Last year, the Trump administration ended a key payment to insurers that helped lower the cost of insurance for lowincome Americans who purchased marketplace insurance.

And the Justice Department declared this month that it will no longer defend the health law in a federal court case filed by 20 states, leaving vulnerable a provision that protects consumers from being denied coverage based on existing medical conditions.

Administration officials would not say when the funding details will be publicly released, leaving navigator groups in limbo on budgets to prepare for this year’s enrollment period.

Last year, the Trump administration cut funding to the navigator program by over 40 percent weeks before the start of signups. While the administration has not revealed budgets for this year, HHS officials noted that limited resources are a factor for the proposed regulatory overhaul this year.

Critics of the administration’s handling of the Affordable Care Act say the delayed navigator funding and program changes are more proof that the administration has continued to target Obama’s signature health care law.

“This is one more attempt to undermine the Affordable Care Act,” said Lisa HamlerFugitt, executive director of the Ohio Association of Foodbanks.