A new report dives into how the Trump administration has scrubbed plenty of references to the Affordable Care Act from its websites.
The Sunlight Project, a nonpartisan group focused on online transparency, analyzed (PDF) changes to websites across the Department of Health and Human Services (HHS) and identified 26 instances where the agency changed or removed references to the ACA.
For example, it removed a link to Healthcare.gov from the footer of its Administration for Children and Families page and deleted some resources for navigators, such as a set of best practices for outreach to Hispanic communities.
HHS also overhauled the “Apply for Health Insurance” page on Healthcare.gov and removed the ACA as a category on the FAQ for its main site.
These changes have been used to divert attention to the administration’s own initiatives—such as short-term health plans—that critics say undermine the Obama era’s signature health law.
While federal websites might be expected to have content change between administrations, the foundation makes the argument that the websites have followed a pattern of systemic and "surgical" removals of ACA information "to undermine the ACA and informally effect policy change."
“We show how website changes have reflected or enhanced the impact of various policy actions that have been implemented to undercut the ACA, like defunding navigator programs that reduce their outreach capacity and limiting access to Healthcare.gov and ACA enrollment,” the group wrote in an accompanying blog post.
An HHS spokesperson, however, told FierceHealthcare that these kinds of changes are part of routine updates to ensure information is up-to-date and not redundant. In addition, information that has been removed is archived, and thus still available.
“The accusations and conclusions expressed by the Sunlight Foundation and others are not supported by the facts that under the Trump administration insurance markets have shown greater stability, premiums have come down, options have increased and enrollment in the ACA has remained relatively stable,” the spokesperson said.
The report also includes several recommendations for HHS—and which could apply to other agencies as well—that they can use to evaluate what information to remove while avoiding potentially harmful effects.
For one, providing notice of when information on Healthcare.gov will be updated could prevent people from losing access to key information when they need it most—during open enrollment. Another suggestion is ensuring that there’s a repository of information for navigators available and that they have easy access to archived data.
“Until rules and systems are put in place, censorship on federal agency websites will remain a largely unregulated tool for the executive to use,” the report reads.