When Trump administration officials decided to cut back on advertising during the final, critical days of the last Affordable Care Act signup period, they didn’t analyze how that might affect enrollment and haven't looked into it since, according to a new government watchdog report.
The report, which the Department of Health and Human Services Office of Inspector General produced at the request of Senate Democrats, laid out the timeline of events surrounding HHS’ cancellation of the ads this past January and how it came to that decision.
At the time, a senior communications adviser from HHS said that the agency chose to pull back “the most expensive and least efficient” part of the ad campaign, noting that “we aren’t going to continue spending millions of taxpayers’ dollars promoting a failed government program.”
But advocacy groups slammed the decision, arguing that the move would result in fewer signups for ACA exchange plans. Ultimately, 12.2 million people enrolled in 2017 exchange plans, which was half a million fewer than the previous year and represented a reversal of the trend of enrollment gains seen under the Obama administration.
The OIG’s report does not independently assess how the advertising cut affected enrollment or whether it saved the government money. But it does reveal details about the briefing materials that the Office of the Assistant Secretary for Public Affairs provided to officials on the HHS beachhead team about the cancellation.
“Although the materials mention that outreach close to the deadline would be critical to enrolling young and healthy consumers, the materials did not contain a full analysis of the potential impact that canceling outreach might have on enrollment,” the report said.
“CMS and ASPA reported that since the cancellations, they have not analyzed how the cancellations affected marketplace enrollment,” it continues.
As for cost savings associated with the move, the public relations firm Weber Shandwick estimated that the dollar value of canceled outreach that could be recoverable for HHS was $5.2 million, according to the report. Another firm, Elevation, estimated the value of canceled outreach was $400,000—which CMS said could be recovered for HHS.
The Trump administration may have lost some government money, however, by first issuing a directive to cancel all ACA marketplace outreach, then modifying those instructions to only cancel ads for which payment could be recouped.
“Weber Shandwick estimated that the dollar value of outreach that it had already canceled, before receiving the updated instructions, was approximately $1.1 million in costs that could not be recovered for HHS,” the report said.
As it turns out, the Trump administration’s advertising cuts in January were just the tip of the iceberg. It has since said it would slash the advertising budget for the upcoming open enrollment period by 90% and funds for the ACA navigator program by about 40%. A recent analysis by a former Obama administration official estimated that the advertising cut alone would decrease enrollment by at least 1.1 million.
In addition, a slew of organizations that previously worked with the Obama administration on ACA outreach have said they’ve heard nothing from the new administration.