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ACA outreach programs facing uncertainty, possible budget cuts

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The future is unclear for state Affordable Care Act advertising and outreach programs as they still have not received their federal grants for 2018 with two critical deadlines approaching.

Both the Healthy Start Navigator Project and West Virginia Navicare, which both assist people in enrolling in insurance through public exchanges under the ACA, also known as Obamacare, have not received their third year of grant funding, expected Sept. 1.

The organizations had funding slated for their third and final year, but received an Aug. 31 news release from the Centers for Medicare and Medicaid Services stating the agency plans to cut federal support for the Navigator program by 90 percent for the coming year from 2016 levels.

Additionally, the release states individual grantees under the program will now receive funding depending on how they met their enrollment quotas from the prior year.

For the month of September, West Virginia University has stepped up to provide stopgap funding for the Healthy Start Navigator Project through Sept. 30. West Virginia Navicare does not have interim funding. However, Jeremy Smith, its program director, said because Navicare operates under the umbrella operation of First Choice Services, which also offers gambling addiction and substance abuse hotlines, it should be able to keep its lights on until the funding issue is resolved.

Smith said Navigator programs help under-served populations work through the tricky, jargon-filled world of enrolling in a health insurance plan.

“We mainly focus on people that live in rural areas, have low literacy levels, have no internet availability, or other vulnerable populations that just may not be able to figure out their health insurance options themselves,” he said.

Several important deadlines are creeping up for the ACA. For one, the open enrollment period for the exchanges begins Nov. 1 and closes Dec. 15. Smith said that window is half as long as it was last year.

Additionally, insurance providers have until Sept. 27 to decide if they want to participate in Obamacare exchanges for next year. Cuts to outreach could threaten projected demand, which could scare off insurers.

Smith said he estimates Navicare enrolled roughly 1,000 people last year in either the exchanges or Medicaid, and worked with a few thousand more.

According to an emailed statement from Healthy Start, its navigators have directly enrolled 500 West Virginians into health plans and offered one-on-one assistance to 2,000 more.

The funding cuts have raised concern President Donald Trump’s administration is attempting to undermine or destabilize the markets for political reasons. In a Sept. 11 letter to Department of Health and Human Services Secretary Tom Price and CMMS Administrator Seema Verma, House Democrats requested information on the administration’s plans to cut marketing and advertising for the open enrollment period by 90 percent.

“We are concerned that the Administration’s decision to cut funding for the Navigator program is driven neither by concerns regarding the effectiveness of Navigators nor by a desire to safeguard taxpayer dollars,” the letter states. “Rather, it appears that the decision fits within a pattern of Administration efforts to depress enrollment and sabotage the ACA.”

That same day, an automated email from the program’s grant administrators states final funding information will be available by the end of the week.

Instability under the law has been a mainstay of 2017. Though the House of Representatives voted to gut the law, the repeal effort came up one vote short in the U.S. Senate in July in a late-night showdown.

However, efforts are ongoing to repeal the law. Republican Senators Lindsey Graham, Bill Cassidy, Dean Heller and Ron Johnson, introduced a repeal-and-replace bill Wednesday similar to earlier efforts waged over the summer.

Across the aisle, Senator and former presidential candidate Bernie Sanders introduced a Medicare for all bill Wednesday as well.

For any bill to have a realistic chance of passing, the Senate would need to vote on it by Sept. 30, when it loses procedural protections under budget reconciliation rules, at which point it would need 60 votes to run.

Reach Jake Zuckerman at, 304-348-4814 or @jake_zuckerman on Twitter.

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