The fallout over the Trump administration’s decision to slash Affordable Care Act outreach funding shows no signs of slowing down.
On Monday, four Democrats from the House Energy and Commerce Committee sent a letter to the two top federal health officials demanding answers about the funding cut and chastising the administration for what it sees as a pattern of poor stewardship of the healthcare law.
“The administration’s continued efforts to depress marketplace enrollment and sabotage the ACA threaten to destabilize insurance markets and raise premiums for millions of consumers, contrary to the president’s promise to provide quality, affordable ‘insurance for everybody,’” they wrote.
The Centers for Medicare & Medicaid Services said Aug. 31 that it would cut funding for open enrollment promotional activities by 90% and reduce funding for the ACA’s navigator program by about 40%, arguing that the smaller amount of money will be better spent.
That decision appears to have been made at the last minute, per a report from Charles Gaba of ACAsignups.net. Just one day before CMS announced the funding cut, it was poised to award the navigator program a $60 million grant—a funding level similar to the amount it awarded in 2016.
What’s more, Vox reported that the navigator program currently has no funding at all, as last year’s grants ran out at the beginning of the month and the administration has not yet awarded funding for next year. The resulting uncertainty has led some navigator groups to lay off staff members.
On Tuesday, 31 House Democrats sent a letter (PDF) urging the Trump administration to release promised funding for the ACA's navigator program, saying navigators are "essential to the success of open enrollment, which begins just a few weeks from now."
Advocacy groups, meanwhile, worry that there is no way to make up for the void left by the federal government’s reduced involvement in ACA outreach, according to the Washington Examiner.
"It is impossible to replace the funding and it is impossible to replace the system because the administration knows who is coming to visit the website and might need a nudge," said Leslie Dach, campaign chairman for the group Protect Our Care.
Even if more nonprofits get involved, added Elizabeth Hagan, associate director of coverage initiatives for Families USA, it’s unlikely they will be able to fill such a significant gap in funding.
Editor's note: This article has been updated to include information about the most recent letter from House Democrats.