Since healthcare.gov went live in the fall of 2013, no state in the union has had more people sign up for the Affordable Care Act than Florida, which is one reason why Tampa Democratic U.S. Rep. Kathy Castor was livid this week while talking about the Trump administration’s decision to slash funding by 70 percent this year for an outreach program that helps people sign up for health insurance.
“The Trump administration acted to essentially wipe out outreach in consumer assistance for millions of Americans,” Castor said on a conference call.
A full 1.7 million Floridians have signed up for coverage under the Affordable Health Care Act (a.k.a. “Obamacare”) since it first became available to the public in the fall of 2013. Castor said that never could have happened without the help of federal employees called “navigators,” who assist and reach out to the public to get them signed on to the health insurance program.
University of South Florida Health in Tampa, partnering with the Family Health Care Foundation, has received the most funding in the U.S. for hiring navigators to help citizens through the health care sign up process. Since 2013, the groups have received between $4.2 million and $5.9 million. Because of federal cuts, that number will be greatly reduced this year, as will grants throughout the country.
Jodi Ray administers the program with USF Health. She told USA Today that the severe cut will make for some hard choices when it comes to helping citizens during the next open enrollment period in November.
“Do we look at what’s easiest to get most numbers (of signups), or do we concentrate on those who are the most time-consuming to assist?” Ray asked. “We’re putting one population against another.”
The Centers for Medicare and Medicaid Services (CMS) announced on Tuesday that only $10 million will be available in 2018. That’s down from $36. 8 million a year ago, and down from $63 million that the Obama administration made available in their last year in office. In explaining the funding cut, the federal agencies said that navigators had failed to enroll a “meaningful” amount of people through the federal health care exchanges, and not nearly enough people to justify the millions of federal dollars spent on the program. They said during 2016-2017, 17 navigator groups enrolled fewer than 100 people at an average cost of $5,000 per enrollee, and nearly 80 percent of navigators failed to reach their enrollment goal.
By contrast, they said that private insurance agents and brokers who assisted with getting people signed up with the ACA did it at at just $2.40 per enrollee.
“It’s time for the Navigator program to evolve, which is why we are announcing a new direction for the program today. This decision reflects CMS’ commitment to put federal dollars for the Federally-facilitated Exchanges to their most cost effective use in order to better support consumers through the enrollment process,” said CMS Administrator Seema Verma.
Trump and Republicans in Congress campaigned in 2016 to overthrow the Affordable Care Act, and came within a single vote of doing so in the U.S. Senate in 2017, but were ultimately unsuccessful.
Last month, the Trump administration said it would not defend a lawsuit filed by Florida and 19 other states that would do away with crucial parts of the Affordable Care Act, such as the requirement that says insurance companies must sell health policies to people regardless of pre-existing health conditions, and also the requirement that prevents insurance companies from charging people more because of those health conditions.
Florida Governor Rick Scott has been a leading critic of the ACA, but he has assiduously avoided saying what he thinks about the Trump administration’s r
efusal to defend the law. The Florida Democratic Party, meanwhile, continually calls on reporters to ask the governor whether he will tell Trump to “stop his attacks on pre-existing conditions?”
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