HHS funding for some ACA helpers cut by more than 60 percent

By Juliet Eilperin and Amy Goldstein / The Washington Post

WASHINGTON — Health and Human Services officials have informed grass-roots groups that assist with enrollment under the Affordable Care Act that their funding will be reduced by as much as two-thirds, a move that could upend outreach efforts across the country.

The groups, which fund organizations known as “navigators,” had been braced for the cuts since the Trump administration announced two weeks ago that it would shrink overall program funding by 41 percent and slash the department’s ACA advertising budget from $100 million to $10 million. At the time of the announcement, HHS officials said the outreach effort wasted taxpayers’ money.

But advocates of the navigator program, including congressional Democrats and some Republicans from rural states, said the deep cuts would undermine any effort to help consumers get insurance coverage once open enrollment begins on Nov. 1. And in some instances, the funding reductions made official late Wednesday night were much deeper than 41 percent, raising questions about some state programs’ viability and the fairness of the administration’s method for deciding how much money each group gets.

Navigator groups perform a range of services during the ACA’s annual enrollment season. They help individuals learn which health plans offered on state and federal insurance exchanges would best suit them, walk consumers through the sign-up process and conduct general outreach to communities about how to obtain coverage under the law. The program’s supporters argue that it is particularly critical during the upcoming six-week enrollment period, which is half as long as last year and comes after Republicans’ high-profile attempt to repeal the 2010 health-care law.

But HHS officials have repeatedly questioned the value of paying navigators. Late last month, department spokeswoman Caitlin Oakley issued a statement calling it “ineffective” and saying that funding for this next enrollment period would be “in proportion to their performance.”

At the Missouri Association of Area Agencies on Aging, which spread nearly $920,000 in navigator money among seven agencies across the state last year, executive director Catherine Edwards learned early Thursday morning that amount would be cut by 62 percent.

“I’m a wee bit nauseous, truth be told,” Edwards said a short time later, adding she is now consulting with her colleagues to determine what they can do with just under $350,000.

Take Care Utah, a network of nonprofits focused on helping people obtain health insurance, consists of roughly 90 navigators, enrollment specialists and insurance brokers across the state. Its director, Randal Serr, learned Thursday morning when he got to his office that his organization had suffered a 61 percent cut, from $740,000 to $289,584.

“We will have to make some tough decisions, there’s no way around it,” Serr said in an email.

HHS officials could not immediately be reached for comment Thursday.

As recently as May, federal officials had told Edwards that her association could expect to receive a similar grant as last year, so it had prepared a budget based on the 2016 figure. She now is wondering how she can proceed with the digital and social media campaign already planned, especially if many individual navigators may be laid off due to the funding cut.

“At what point does it become ineffective to do any of that?” she asked. “What would I be advertising? I guess I could be advertising about navigator assistance. But in terms of the in-person help, we may not have those people.”

Even before the emails began popping up in organizations’ inboxes, HHS’s abrupt announcement about an overall funding cut had created havoc for enrollment helpers around the country. It came at the exact time of year when their work becomes intense, ramping up for the always feverish enrollment season, and left them with no money to spend during the first two weeks of September because their previous grants had expired as of Sept. 1.

In frantic phone calls the past two weeks with their liaisons within a sub-agency of HHS’s Centers for Medicare and Medicaid Services, most navigators were told that they could not depend on the new funding being retroactive to the start of the month — so they would be best off not spending any money in the meantime, they heard. The liaisons told the navigators they didn’t have any information because “higher-ups” were making all the decisions, leaders of several navigator groups said.

According to notices sent to organizations late Wednesday, these groups now have just two weeks to send HHS a revised budget and work plan, which federal officials then must approve. They will be allowed to use 10 percent of their award to cover costs they have incurred since Sept. 2, and the reimbursement will be restricted to certain expenses.

Administration officials said in late August that they would tie the grant awards to navigator groups’ past performance: While all would get at least $10,000, the size of a group’s grant would hinge on the percentage of its target enrollee total that it met last year.

Serr said in an interview this week that applying such a test is “absurd, for a number of reasons,” particularly because that in past years federal officials had encouraged his group and others to set ambitious goals. He noted that Utah had the country’s third-highest increase in federal marketplace enrollment last year, behind Hawaii and South Dakota.

“They don’t count all the other ways we help people,” he said. “This is completely a political decision, and not a decision made by people who do this for a living.”

While congressional Democrats have been most critical of the administration’s plan to cut navigator cuts, some GOP officials have warned it could hurt their constituents as well.

Lori Wing-Heier, director of the Alaska Department of Commerce, Community and Economic Development’s insurance division, testified on Capitol Hill last week that in some remote parts of the state “there’s not an insurance broker or a consultant to be found.”

“We are very concerned that it will have a major impact on our enrollment,” Wing-Heier told the Senate hearing. “This would be devastating, to our population.”

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Nation-World

FILE - Britain's Queen Elizabeth II looks on during a visit to officially open the new building at Thames Hospice, Maidenhead, England July 15, 2022. Buckingham Palace says Queen Elizabeth II is under medical supervision as doctors are “concerned for Her Majesty’s health.” The announcement comes a day after the 96-year-old monarch canceled a meeting of her Privy Council and was told to rest. (Kirsty O'Connor/Pool Photo via AP, File)
Queen Elizabeth II dead at 96 after 70 years on the throne

Britain’s longest-reigning monarch and a rock of stability across much of a turbulent century died Thursday.

A woman reacts as she prepares to leave an area for relatives of the passengers aboard China Eastern's flight MU5735 at the Guangzhou Baiyun International Airport, Tuesday, March 22, 2022, in Guangzhou. No survivors have been found as rescuers on Tuesday searched the scattered wreckage of a China Eastern plane carrying 132 people that crashed a day earlier on a wooded mountainside in China's worst air disaster in more than a decade. (AP Photo/Ng Han Guan)
No survivors found in crash of Boeing 737 in China

What caused the plane to drop out of the sky shortly before it was to being its descent remained a mystery.

In this photo taken by mobile phone released by Xinhua News Agency, a piece of wreckage of the China Eastern's flight MU5735 are seen after it crashed on the mountain in Tengxian County, south China's Guangxi Zhuang Autonomous Region on Monday, March 21, 2022. A China Eastern Boeing 737-800 with 132 people on board crashed in a remote mountainous area of southern China on Monday, officials said, setting off a forest fire visible from space in the country's worst air disaster in nearly a decade. (Xinhua via AP)
Boeing 737 crashes in southern China with 132 aboard

More than 15 hours after communication was lost with the plane, there was still no word of survivors.

Former Rep. Matt Gaetz, R-Fla., center, arrives at the U.S. Capitol in Washington D.C. with Sen. JD Vance, R-Ohio, right, the vice president-elect, on Wednesday morning. Gaetz withdrew from consideration Thursday, saying he was an unfair distraction to the transition. (Haiyun Jiang / The New York Times)
Matt Gaetz withdraws from consideration as attorney general

“It is clear that my confirmation was unfairly becoming a distraction,” Gaetz wrote Thursday on X.

Attendees react after Fox News called the presidential race for Former President Donald Trump, during an election night event at the Palm Beach County Convention Center in West Palm Beach, Fla., on Wednesday. Trump made gains in every corner of the country and with nearly every demographic group. (Haiyun Jiang / The New York Times)
Donald Trump returns to power, ushering in new era of uncertainty

Despite criminal convictions and fears of authoritarianism, Trump rode frustrations over the economy and immigration.

Voters cast their ballots at a polling place inside the Weisman Art Museum at the University of Minnesota in Minneapolis on Election Day, Tuesday, Nov. 5 2024. Voters headed into polling stations on Tuesday in the closing hours of a presidential contest that both major parties said would take the country in dramatically different directions, capping a contentious and exhausting 107-day sprint that began when President Joe Biden abandoned his bid for a second term.  (Caroline Yang/The New York Times)
Live updates: Georgia called for Trump

The Daily Herald will be providing live updates on national election developments throughout Tuesday.

Liam Payne performs during the Jingle Ball at Madison Square Garden in New York in 2017. Payne, who rose to fame as a singer and songwriter for the British group One Direction, one of the best-selling boy bands of all time, died after falling from the third floor of a hotel in Buenos Aires on Wednesday. He was 31. (Chad Batka / The New York Times)
Liam Payne, 31, former One Direction singer, dies in fall in Argentina

Payne rose to fame as a member of one of the bestselling boy bands of all time before embarking upon a solo career.

In this photo taken from video provided by the Ukrainian Presidential Press Office, Ukrainian President Volodymyr Zelenskyy speaks to the nation in Kyiv, Ukraine, Sunday, Feb. 27, 2022. Street fighting broke out in Ukraine's second-largest city Sunday and Russian troops put increasing pressure on strategic ports in the country's south following a wave of attacks on airfields and fuel facilities elsewhere that appeared to mark a new phase of Russia's invasion. (Ukrainian Presidential Press Office via AP)
Ukraine wants EU membership, but accession often takes years

President Volodymyr Zelenskyy’s request has enthusiastic support from several member states.

FILE - Ukrainian servicemen walk by fragments of a downed aircraft,  in in Kyiv, Ukraine, Friday, Feb. 25, 2022. The International Criminal Court's prosecutor has put combatants and their commanders on notice that he is monitoring Russia's invasion of Ukraine and has jurisdiction to prosecute war crimes and crimes against humanity. But, at the same time, Prosecutor Karim Khan acknowledges that he cannot investigate the crime of aggression. (AP Photo/Oleksandr Ratushniak, File)
ICC prosecutor to open probe into war crimes in Ukraine

U.N. human rights chief Michelle Bachelet confirmed that 102 civilians have been killed.

FILE - Refugees fleeing conflict from neighboring Ukraine arrive to Zahony, Hungary, Sunday, Feb. 27, 2022. As hundreds of thousands of Ukrainians seek refuge in neighboring countries, cradling children in one arm and clutching belongings in the other, leaders in Poland, Hungary, Bulgaria, Moldova and Romania are offering a hearty welcome. (AP Photo/Anna Szilagyi, File)
Europe welcomes Ukrainian refugees — others, less so

It is a stark difference from treatment given to migrants and refugees from the Middle East and Africa.

Afghan evacuees disembark the plane and board a bus after landing at Skopje International Airport, North Macedonia, on Wednesday, Sept. 15, 2021. North Macedonia has hosted another group of 44 Afghan evacuees on Wednesday where they will be sheltered temporarily till their transfer to final destinations. (AP Photo/Boris Grdanoski)
‘They are safe here.’ Snohomish County welcomes hundreds of Afghans

The county’s welcoming center has been a hub of services and assistance for migrants fleeing Afghanistan since October.

FILE - In this April 15, 2019, file photo, a vendor makes change for a marijuana customer at a cannabis marketplace in Los Angeles. An unwelcome trend is emerging in California, as the nation's most populous state enters its fifth year of broad legal marijuana sales. Industry experts say a growing number of license holders are secretly operating in the illegal market — working both sides of the economy to make ends meet. (AP Photo/Richard Vogel, File)
In California pot market, a hazy line between legal and not

Industry insiders say the practice of working simultaneously in the legal and illicit markets is a financial reality.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.