After Failing to Repeal the ACA, the Trump Administration Is Actively Trying to Sabotage It

We all know President Trump is a sore loser. After several failed attempts to repeal the Affordable Care Act since January, the Trump administration is now trying to sabotage the ACA. In the last week, President Trump has taken several high-profile steps to undermine the ACA—cutting off cost-sharing subsidies and signing a troubling new executive order that will destabilize the marketplace—but his Administration is also doing things that are not so obvious, like preventing people from signing up for health coverage.

Back in July, Trump tweeted that Congress should “let Obamacare fail….” Reading between the lines (barely), news outlets interpreted this to mean that there might be efforts by the Trump Administration to sabotage open enrollment.

Well, they were right, and so far, here’s how the Administration has tried to prevent individuals from getting health coverage through the ACA marketplaces:

In April, the Administration cut the open enrollment period in half from three months to just 45 days—November 1 to December 15. This is a significant cut to the enrollment period; in 2016 about a half a million people purchased plans each week of open enrollment, but the week with the single largest number of plans purchased occurred between Dec. 13 and Dec. 19—right before when many people take off for holidays—when just over 4 million people purchased coverage. The corresponding week on this year’s calendar is December 18 to 22, and it is cut out of the enrollment period.

In August, the Department of Health and Human Services (HHS) cut the budget for promotion and education about the Affordable Care Act by 90 percent. This budget was used to create ads and public service announcements to educate Americans about their insurance options, and to notify the public about open enrollment, and important deadlines. The budget was gutted because the administration stated that advertising was unnecessary. Unfortunately, the Administration also admitted that they had absolutely no data to back up that statement. And, with all of the changes to enrollment and the confusion and uncertainty created by the Administration around healthcare, information and education is more critical than ever this year.
On top of the cuts to information and education campaigns, the Administration has also cut funding for “navigators,” who help people enroll, by 40 percent. Navigators are critical to the open enrollment process because they are familiar with the available plans, and can help individuals and families determine which plans are right for their needs. Cutting the navigator budget means that it will be harder for people to get help navigating the enrollment process.
The Trump administration has also failed to reach out to outside groups like NWLC to promote the open enrollment season, and has abandoned partnerships with dozens of groups that specifically promoted open enrollment to Latinos. Traditionally, the administration has sought help from community partners and nonprofit organizations focused on health in order to raise awareness about open enrollment, and to make sure that information is available to individuals and families before they choose a plan. The Trump administration has either abandoned or failed to communicate at all with these partners regarding the open enrollment process, leaving another huge gap in critical outreach and education. Altogether, this means that fewer people will receive the message about the start of, and changes to, open enrollment.

In September, news emerged that the Administration plans to shut down healthcare.gov, the website that people need to access in order to enroll in health coverage and choose their plans from the marketplace, for 12 hours every Sunday in the upcoming open enrollment season for “maintenance”; but former HHS officials from the Obama administration say there is absolutely no need for this and that healthcare.gov was in its best shape yet when Trump entered office. It’s no secret that Sunday is a day when many individuals could be shopping for their insurance. The Department of Health and Human Services will also shut down healthcare.gov overnight on the first day of open enrollment, Nov. 1. Over thirty-six states use healthcare.gov for their marketplaces. Shutting the marketplace down for half of every Sunday, and on the first day of open enrollment, is a clear attempt to reduce the number of people who can enroll for health insurance.

Contrast this to 2016, when—under the Obama Administration’s oversight—outreach was a major priority, with $62.5 million in grants going to nonprofits and health clinics to help Americans sign up for health coverage. Outreach to millennials was also paramount under the Obama administration; in addition to the use of phone calls and emails to get young people signed up, the Obama Administration partnered with new media organizations and live-steam platforms to reach millennials.
Through these outreach efforts, enrollment numbers rose from over 3 million people in 2014, to 11.7 million in 2015. Of those who enrolled in coverage between the ages of 18 and 44, about 55 percent were women. While the pace of enrollment jumped drastically early on in 2016, it slowed after Trump was elected, and once in office, the Trump Administration’s early blows to Obamacare—such as ceasing communications at the end of the last open enrollment season–decreased enrollment almost immediately.

So the bottom line is this: By doing whatever it can to sabotage enrollment, it’s clear that the administration is trying to score a political win by forcing the ACA to fail. This continued attempt to sabotage the ACA will destroy the opportunity for healthcare access for millions of people. Trump is playing politics with the lives and health of millions of people—(another) deplorable move on the part of the Administration.