In Tenn., promoting enrollment in tenuous health care
NASHVILLE, Tenn. — Sharon Barker is not used to new health insurance customers in deepest summer, long before the enrollment season for the Affordable Care Act. But this year, everything is different.
Despite surviving Republican efforts to repeal it, the law known as “Obamacare” remains vulnerable. President Donald Trump has repeatedly threatened to end billions of dollars in payments to insurance companies, but his administration decided this week to continue them for another month.
An even more crucial question is whether administration officials who openly detest the law will lead a vigorous nationwide push to persuade the uninsured to buy policies sold under its banner, and existing customers to keep their coverage, when open enrollment for next year starts on Nov. 1.
The evidence so far suggests they will not. The administration recently ended $23 million worth of contracts with two companies that helped people sign up for coverage. It also is cutting the enrollment period in half in most states, to 45 days. A number of advocacy groups that worked closely with the Obama administration to get the word out about open enrollment have heard nothing from the Trump administration about re-upping the partnerships this year.
All of this has Barker and other Obamacare enrollment counselors around the nation, many of whom rely on federal grants to carry out their work and to keep their jobs, revving up earlier than usual, and bracing for the strange new challenge of promoting coverage that the president is attacking at the same time. They are not even certain the law’s mandate that most Americans have health insurance or pay a tax penalty will be enforced.
A recent Friday found Barker passing out flyers about open enrollment at a back-to-school fair in East Nashville, Tenn. To every parent and grandparent who strolled past, she asked, “You have health insurance?” Nearby was her favorite prop: a wheel that passers-by could spin with a dial that landed on terms like “deductible” and “penalty.”
For the law’s first four enrollment seasons, the Obama administration spent heavily on advertising, recruited celebrities like Katy Perry and companies like Uber to spread the word and scrutinized data to pinpoint potential customers. But this year, communitybased enrollment groups, known as navigators, may be largely on their own.
“This is going to be the heaviest lift we have ever tried to undertake,” said Jessie Menkens, navigator program coordinator for the Alaska Primary Care Association. “We will be shouting out for people to recognize this really is not over — that regardless of what deliberations are happening in Washington, this is still truly the law of the land.”
The approximately 100 navigator groups around the country, which received $63 million in federal grants last year, are not sure the Trump administration will renew those grants, which are supposed to be awarded next month. Matt Slonaker, executive director of the Utah Health Policy Project, said he had had encouraging conversations with officials at the Centers for Medicare and Medicaid Services (known as CMS), but “no one will know for sure until the grants are finalized.”
Slonaker also said that at a conference that CMS held for navigators in June, employees of the agency said the federal government would not run any ads to promote open enrollment this year. A spokeswoman for the agency would not confirm whether that was true.