Funding for the Affordable Care Act (ACA) navigator program will get cut to just $10 million, the Centers for Medicare & Medicaid Services (CMS) announced Feb. 14.
It’s one of the agency’s first official moves signaling the priorities of the CMS under President Donald Trump and Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.
The navigator program received $98 million in the 2024 plan year but only enrolled 92,000 consumers, accounting for 0.6% of selections through federally facilitated exchanges (FFEs) in the open enrollment period, the agency said. The average cost per enrollment was more than $3,000 for 12 organizations receiving funding.
“These numbers indicate that navigators are not enrolling nearly enough people to justify the substantial amount of federal dollars previously spent on the program,” the CMS argued.
A spreadsheet provided by HHS showed grant funding designated for 56 organizations including the University of South Florida, Legal Aid of North Carolina and the Illinois Primary Health Care Association.
Now, FFEs can “focus on more effective strategies” to improve outcomes and reduce user fees, the CMS said in a news release. It is approximately a 90% reduction in funding.
“This change will directly benefit people enrolled without subsidies who pay the full premium for their health insurance,” the department said, noting the program is funded through user fees that are directly passed through to the premium.
The federal government had committed to spend up to $500 million over five years on the Navigator program, awarding a batch of $100 million in August. A stated intention of the program was to help enroll people from underserved groups.
Now, the CMS expects to save $360 million over the next four years, ending August 2029. The agency said it spent just $10 million on the program the year before the COVID-19 pandemic and achieved similar outcomes. Additionally, post-enrollment assistance helped just 86,000 consumers in 2024, versus 206,000 people in 2019, the agency said.
"The navigator program is a total and unnecessary boondoggle and bears some responsibility for at least a part of the massive number of ineligible people in the exchanges," said Brian Blase, president of conservative think tank Paragon Health Institute, in a post on X. "Insurers are making enormous money in the ACA market. They can spend their own money advertising."
The Trump administration cut funding to navigators each year in his first term, as well as cut advertising to HealthCare.gov by 90%, saying the need for marketplace visibility was diminished. Since then, enrollment in the ACA has increased substantially.
"The announcement of the funding cuts does not reference the 292,000 people who Navigators helped enroll in Medicaid or the millions of individuals helped with post-enrollment and health insurance literacy assistance," said KFF.
Opposition to programs designed to increase individual marketplace enrollment will be unsurprising to the Trump administration's critics.
“This previous grant funding level reflects a far more efficient $211 per enrollment,” the CMS said.
President Joe Biden’s CMS said the program was important for connecting individuals with affordable health insurance. Navigators give free assistance to people looking for insurance on HealthCare.gov, helping individuals fill out enrollment forms and complete post-enrollment services. They also help people obtain Medicaid and Children’s Health Insurance Program (CHIP) coverage.
More than 23 million people have ACA coverage through the marketplace.
"By cutting funds to health care navigators by 90%, eviscerating those who help Americans sign up for health care coverage, President Trump violated his repeated promise to not harm access to health care through the ACA or Medicaid," said Families USA Executive Director Anthony Wright in a statement. "In 2024 alone, navigators helped more than 384,000 families choose affordable health coverage through Medicaid or the marketplace that suited their circumstances."
States with FFEs in the next grant period for plan year 2026 will be impacted.
Updated: March 7. This story now includes additional context.