Despite US president Donald Trump’s repeated claims that Obamacare is dead, or that it will implode, the Affordable Care Act (ACA) isn’t going anywhere yet. But you wouldn’t necessarily know that from the amount of enrollment outreach and information circulating. Last year, the Centers for Medicare and Medicaid Services (CMS) spent over $100 million in advertising and promotional efforts for ACA signup. This year, the budget is $10 million, the CMS announced on Aug. 31.
This means that just a fraction of enrollment deadline reminders will go out this year compared to last year. The CMS is also halving the federal enrollment window to six weeks, from Nov. 1 to Dec. 15, 2017. In previous years, the window was three months, between Nov. 1 and Jan. 31.
The CMS also announced cuts in funds for so-called “navigators,” individuals or organizations responsible for helping citizens enroll in healthcare policies through the federal exchange or their state’s marketplace. In announcing the funding cuts, the CMS noted that last year these navigators collectively received over $60 million in grants, but nearly 80% of them did not meet their enrollment goals. The funding for the upcoming enrollment period will be performance-based: Only the navigators that met their goals will receive the same amount as last year, while others will receive a portion corresponding to the fraction of the goal they achieved.
In 2017, 12.2 million people signed up for Obamacare, slightly less than the 12.7 million in 2016, the year with the highest enrollment since the program started in 2013. The combination of the shorter enrollment period, and the limited outreach funds for advertising and navigator grants, is likely to result in a reduced number of eligible beneficiaries enrolling.
From the perspective of a government who wants to prove Obamacare is destined to fail—and one struggling to offer an alternative—this is a logical, if cynical, move, and one of a few weapons the administration still has to compromise the ACA. The administration attempted something similar in January 2017, by suspending ads in the last few days of the enrollment campaign for 2017. But for those interested in assuring health coverage for American citizens, the cuts in outreach and navigators are worrisome. That’s why a few states that run their own policy exchanges have decided to extend the enrollment period beyond the federal government’s wishes.
Below is a breakdown: