U.S. cuts funds to pitch health care enrollment

WASHINGTON — President Donald Trump’s administration on Thursday announced sharp cuts in programs promoting health care enrollment under the Patient Protection and Affordable Care Act for next year.

Advertising will be cut from $100 million spent on 2017 sign-ups to $10 million, Health and Human Services Department officials said.

The $10 million will go to “digital media, email and text messages” an official said, since those methods “have proven the most effective in reaching existing and new enrollees.”

Funding for consumer helpers, called navigators, will be cut about 40 percent, from $62.5 million for 2017 to $36.8 million for next year. That change reflects a new performance-based policy that penalizes navigator programs failing to meet their sign-up targets, administration officials said.

About 12.2 million people signed up for subsidized private health insurance under the health care law this year, many in states that Trump carried in the November election.

Current enrollment is estimated to be around 10 million because of attrition also seen in previous years.

Top Democrats accused the administration of malice.

House Minority Leader Nancy Pelosi of California said the administration is waging a “cynical effort to lower enrollment” that would “create chaos” and increase premiums.

Senate Minority Leader Charles Schumer of New York said the administration “is deliberately attempting to sabotage our health care system,” adding that “the American people will know who’s to blame.”

Sen. Ron Wyden, D-Ore., said the administration was “pulling the rug out” from under Americans.

“The Trump Administration should be doing everything in its power to improve Americans’ access to health care, not cutting efforts that help Americans get coverage,” Wyden said in a statement.

It was unclear how the administration’s latest move might affect an effort in the Senate to craft bipartisan legislation that would stabilize insurance markets.

Trump and congressional Republicans have been unable to deliver on their vow to repeal and replace the 2010 health care law enacted under President Barack Obama, but Trump has repeatedly claimed the program is on the verge of collapse.

On Twitter and in interviews, Trump has threatened to cut off payments to insurers that help reduce consumers’ copays and deductibles.

Still, his administration has continued making payments.

Independent observers say the health law’s insurance markets have problems but are not about to implode.

For next year, all U.S. counties will have at least one participating insurer, though consumers in almost half of all counties will only have a single carrier serving them.

Some major insurers have left the program after taking deep financial losses.

Health and Human Services Department officials announced the cuts in a conference call with reporters Thursday. The three officials who described the details of the cuts refused to be identified by name.

The administration says the government hasn’t gotten much bang for its buck from the advertising and navigator programs, with some enrollment centers signing up very few customers.

By comparison, the Health and Human Services Department said, the combined advertising budget for Medicare Advantage and Medicare prescription drug plans is $9.7 million.

Department officials said the 98 navigator programs funded by the law enrolled fewer than 82,000 people, or less than 1 percent.

Navigators are supposed to guide consumers through the sometimes complicated enrollment process, which involves estimating income for the coming year, proving citizenship or legal residence, and sorting through various health plan options.

For next year, officials said, navigator funding will reflect each sign-up center’s performance.

For example, if a navigator program met 70 percent of its enrollment target, it will get 70 percent of its previous funding.

If it enrolled only 30 percent, its funding will be cut to 30 percent.

However, every center will get some money from the government, even if it’s only a few thousand dollars.

“Judging effectiveness by the amount of money spent, and not the results achieved, is irresponsible and unhelpful to the American people,” department spokesman Caitlin Oakley said in a statement.

“During the upcoming enrollment period, navigators will be funded in proportion to their performance.”

Arkansas is among 17 states that are considered to have state-based insurance exchanges, which carry out their own marketing campaigns.

Using money from a fee it collects from insurers, the Arkansas Health Insurance Marketplace plans to spend $1.25 million on marketing, including television and radio advertising, during open enrollment and throughout much of 2018, down from $2.5 million it budgeted a year earlier.

In addition, the agency will pay Jonesboro-based Enroll the Ridge $554,391 to supply 11 navigators over a one-year period starting Oct. 1.

During the previous signup period, it spent $552,000 on a contract to supply the state with 15 navigators for nine months, from Oct. 1, 2016, through June 30.

The enrollment period for sign-ups under the law is scheduled to start Nov. 1.