No smart business stops investing in marketing and customer support when sales are down. But that’s exactly what the Trump administration is doing by cutting funding for advertising and navigators. The recent announcement that CMS is decreasing Healthcare.gov’s direct marketing budget by 90 percent and reducing funding to navigator entities by almost half is shortsighted for sure.
CMS also announced that FY 2018 funding levels will be based on each entity’s performance in meeting prior enrollment targets. But alarmingly, some navigators have been told that CMS might not count enrollment in Medicaid and CHIP toward the entity’s performance goals, even though navigators were expected to assist anyone in need of coverage regardless of program eligibility.
After all the negative media coverage over repeal of the Affordable Care Act (ACA), effective outreach and public education are particularly crucial this year. The public is more confused than ever about the value of health coverage and the options available to those who do not qualify for Medicaid and do not have access to affordable employer-based coverage. Moreover, this year’s open enrollment period has already been shortened from 12 to six weeks, which increases the necessity of public education to alert potential enrollees about the early deadline and restricted enrollment period.
The lack of outreach and application assistance could also have a negative impact on children’s coverage. There is no doubt that the ACA’s welcome mat has helped accelerate our success in covering more than 95 percent of the nation’s children. Evidence of the welcome mat effect continues to emerge at a time when the federal government’s commitment to health coverage for everyone is in doubt.
The impact on children could be even more pronounced if CMS does not count prior assistance with Medicaid and CHIP enrollment in assessing navigator performance. With reduced funding and the knowledge that Medicaid and CHIP enrollment will not get counted toward performance goals, navigators may be unable to continue their focus on enrolling uninsured individuals in whatever coverage they are eligible for and wind up prescreening so they serve only those eligible for marketplace coverage. This would be regrettable, and serve as just another way federal policy changes can undermine the ACA and our country’s coverage gains.