Trump administration slashes grants to help Americans get Affordable Care Act coverage

The Trump administration's latest action fits a pattern to weaken Obamacare.
(LM Otero / Associated Press)
Washington Post

The Trump administration is eliminating most of the funding for grass-roots groups that help Americans get Affordable Care Act insurance and will for the first time urge the groups to promote health plans that bypass the law’s consumer protections and required benefits.

The reduction, the second round of cuts that began a summer ago, will shrink the federal money devoted to groups known as navigators from $36.8 million to $10 million for the enrollment period that starts in November.

Last August, federal health officials announced they were reducing the navigators’ aid by 41% — from $62.5 million — and slashing a related budget for advertising and other outreach activities to foster ACA enrollment by 90%.


The new reduction of help for navigators, announced Tuesday afternoon by the Centers for Medicare and Medicaid Services, fits within a pattern of moves by the administration to weaken the sweeping healthcare law that President Trump has vowed to demolish. During his first year in office, the president pressed the Republican-led Congress to repeal much of the 2010 law that was one of President Obama’s signature domestic achievements.

Since Congress was unable to pass such a law, Trump and his aides have been taking a series of steps to weaken the law through administration maneuvers. The cuts to grass-roots groups around the country was announced three days after health officials revealed that, because of a pending lawsuit, they were suspending a program created by the law to even out the burden on health insurers whose customers are especially unhealthy or sick.

The president last fall also issued an executive order to try to make it easier for individuals and small businesses to buy health plans that cost less than ACA coverage because they cover fewer medical services and bypass the law’s rules intended to protect people from old insurance practices in which companies had charged higher prices to women, older people and those with preexisting medical conditions.

Since then, the Department of Labor has issued a rule to broaden the use of one such kind of insurance, called “association health plans.” The Department of Health and Human Services is finishing another rule that will broaden the use of short-term insurance plans, originally intended as a brief bridge for people between jobs.

It is those two kinds of insurance that Tuesday’s announcement is requiring groups that apply for navigator grants to encourage clients to buy. Until now, the grants have been used only to help people choose and buy ACA health plans or to help steer people with low incomes toward Medicaid.

For the last five years, when insurance has been available through ACA marketplaces for people who do not have access to affordable health benefits through a job, federal health officials have started every spring working with navigator groups on plans for the coming enrollment season. Tuesday’s notice was the first information CMS has provided this year.