The Trump administration has let funding for Obamacare's $63 million in-person outreach program lapse, leading to layoffs and confusion among nonprofits that enroll vulnerable populations in coverage.
"I have delivered 10 layoff notices to staff members," says Donna Friedsam, director of Covering Wisconsin. "We don't have a funding flow anymore."
The government had previously announced it would cut the budget for Obamacare's navigator program by 41 percent. But right now, the program has no funding at all. Last year's grants ran out on September 1, and the administration still has not awarded next year's money.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.
These groups often work with the most vulnerable populations enrolled under the Affordable Care Act. One-third of those who seek in-person help signing up for coverage do not have internet at home, and one in 10 do not speak English.
Navigator organizations say the administration has not made clear when the 2018 funding will arrive, although it could be as late as September 30. Health and Human Services, which oversees the program, has said that this funding will notbe retroactive, meaning there may be no budget for activities this month, according to three navigators who have spoken with officials there.
"As someone who has worked on many federal grants, this is really unusual," Friedsam says. "Usually if the grant letter shows up late, it still goes back to the project start date. The Trump administration is essentially saying, you need to deconstruct your organization on September 1 and reconstruct it on whatever day we provide funding. In what world is that possible?"
Letting the Obamacare outreach budget lapse goes well beyond the promised 40 percent budget cut. It means that, right now, enrollment groups currently have no budget at all — and no resources to prepare for an open enrollment season that begins in 54 days.
Trump initially planned to cut the budget for Obamacare outreach. But right now, there's no budget at all.
The Obama administration spent $62.5 million in 2016 providing grants to nonprofits and health clinics to help Americans sign up for health coverage. This "navigator" program paid enrollment workers to assist with enrollment and advertise the open enrollment period to their community (through things like phone calls and health fairs).
The Trump administration announced on August 31 it would reduce the navigator program's budget to $36 million. It will focus its budget cuts on the navigator grantees that have fallen short of their enrollment goals. A navigator grantee, for example, who only hit 30 percent of its enrollment goal this year will get just 30 percent of its expected budget for next year (no grantees will be defunded entirely — the first HHS official said they'd set a floor of $10,000 for all participants).
Navigator grantees expected that their new, smaller budgets for 2018 would follow that August 31 announcement because the 2017 budget was set to run out September 1.