Trump HHS Cuts Health-Law Enrollment Outreach To $10 Million, Resolving Long-Standing Concern That Uninsured Americans Were Still Being Told How To Get Insured

The Filing

WASHINGTON. The Department of Health and Human Services announced Tuesday that it would reduce funding for the Affordable Care Act's in-person enrollment program to $10 million, resolving a long-standing concern within the administration that uninsured Americans were still being informed, free of charge, how to obtain health insurance.

The cut to the navigator program, which pays trained counselors to sit with confused consumers and walk them through the federal marketplace, brings the budget down from roughly $63 million in 2016 and $36 million the year before. It follows a separate 2017 decision to slash the marketplace advertising budget by about 90 percent, from roughly $100 million to $10 million, a reduction officials characterized at the time as the elimination of waste, the waste in question being the practice of telling people a law exists.

"We are simply ensuring taxpayer dollars are spent wisely," said a senior HHS official, who explained that navigators delivered a poor return on investment because they helped a finite number of people, each of whom then had insurance and no longer needed a navigator. "An outreach program that succeeds eventually runs out of uninsured people to reach. We have decided to address that inefficiency at the front end."

The President had previously been candid about the broader strategy. "Let Obamacare fail," Trump told reporters in 2017, adding that he would not "own it." Sources within the administration noted that the law could not be made to fail through Congress, where repeal had collapsed by a single vote, and so the work had moved to the quieter venue of the federal budget, where a program can be ended without anyone casting a recorded vote against insured children.

The timing drew praise from sources within the administration, who observed that the outreach cuts arrived alongside the zeroing out of the individual mandate penalty and the expansion of short-term "junk" plans, a coordinated sequence one official likened to removing the lifeguard, draining the pool, and then selling everyone a product called a flotation device that is legally permitted to contain no flotation.

At press time, HHS had confirmed that any American who managed to enroll in coverage despite the agency's best efforts would be counted, in the following year's budget, as fresh evidence that outreach spending was unnecessary.

Who Benefits

§Donald J. Trump, who had pledged to dismantle the Affordable Care Act and discovered that quietly defunding the part of it that tells people the law exists accomplished much of the goal without a single additional vote in Congress.
§Sellers of short-term, limited-duration "junk" insurance plans, whose lightly regulated products the same administration moved to expand the same year, and which became easier to sell once consumers had fewer trained, neutral guides explaining the comprehensive alternatives.
§Commission-paid insurance brokers, who benefit when uninsured consumers turn to a salesperson rather than to a free, federally funded navigator with no product to push.
§The federal budget, in the narrow subsidy-accounting sense, which spends less on premium tax credits each time an eligible American fails to enroll, a savings achieved entirely at the expense of that American's coverage.
§Opponents of the Affordable Care Act generally, who had spent years unable to repeal the law through legislation and were shown that enrollment can instead be suppressed administratively, on a Tuesday, with a press release.

Sourced to the public record · presented without editorial embellishment