Updated Fri., Sept. 8: After unexpectedly announcing extreme cuts to funding to support outreach for the 2018 open enrollment period, the Trump administration has allowed funding to enrollment assistance programs to lapse entirely. According to Sarah Kliff at Vox, who broke this story, the Department of Health and Human Services (HHS) hasn’t told the organizations running these programs when their funding will arrive, but it could be as late as September 30 (their prior grant awards ended as of September 1). And HHS says funding will not be retroactive. That means organizations cannot be paid for any work they do between now and whenever their funding actually does take effect. As someone who has worked in grant-funded organizations for the past 10 years, I can say this is not normal. The federal government does not allow funding gaps in ongoing programs. Period.
If this is not a deliberate act of sabotage targeting the most vulnerable among us, then it is at minimum gross and unforgivable negligence on the part of HHS and the entire Trump administration.
From Kliff’s Vox article: “The sudden funding halt comes at a critical time for the Affordable Care Act. Navigator groups were just beginning to ramp up outreach for the health law’s open enrollment period, which begins November 1. Now, some have done an about-face: They’ve canceled outreach work and appointments with potential enrollees because they have no budget to cover those costs.”
With 40% of the 24 million uninsured people nationwide still unaware of the existence of the marketplace, outreach is absolutely critical to maximizing enrollment. (For more on the impact of cutting funding to outreach, see my post from earlier this week.) If this is not a deliberate act of sabotage targeting the most vulnerable among us (and I believe it is), then it is at minimum gross and unforgivable negligence on the part of HHS and the entire Trump administration.
Original Post Thurs., Sept. 7:
Referring to what he says are leaked documents from the Centers for Medicare and Medicaid Services (CMS), independent blogger Charles Gaba says CMS had already signed off on $60,000,000 in grants to navigator programs before abruptly announcing that funding to these programs would be cut by 41%. (For more information on the cuts to outreach and their potential impact on enrollment, see my post from yesterday.)
In a story that has been picked up by both Politico Pulse and Axios Vitals, Gaba cited (and shared images of) documents he says show that CMS had authorized grants to navigator programs using close to the same funding amounts as last year, and was preparing to notify grantees of their awards, which were to take effect on August 31, the day the cuts were announced. This is consistent with other reports that navigators had been consistently assured by the Department of Health and Humans Services (HHS) that their funding was secure and that their first knowledge of the cuts came when they received the press release.
This is more evidence of deliberate acts by the Trump administration to sabotage enrollment through unpredictable, last minute changes to the playing field.
HHS wouldn’t confirm the report, telling Politico PULSE, “HHS does not comment on alleged, leaked documents.” They went on to say that the only decision that matters is the one they announced on August 31.
Assuming that the documents Gaba has are legitimate, and at least according to Politico and Axios they seem to be, this is more evidence of deliberate acts by the Trump administration to sabotage enrollment through unpredictable, last minute changes to the playing field. These attempts to undermine enrollment while the ACA is still the law of the land are indefensible under any circumstances, but are particularly insidious given the bipartisan healthcare hearings being held in the Senate right now.