Fearing sabotage, groups prepare ObamaCare blitz

State and local groups that help support ObamaCare are springing into action ahead of an enrollment period they fear could be sabotaged by the Trump administration.

Their marketing efforts are expanding, their advertisements are starting earlier, and those that fought repeal are shifting their focus to spreading the word about open enrollment, which begins Nov. 1. 

“Given the fact that we really have received no assurances that we’ll have national support with marketing in advance of open enrollment, it’s really incumbent upon us to do everything we can to highlight [open enrollment] dates,” said Jessie Menkens, Alaska Primary Care Association’s navigator program coordinator.

The Obama administration campaigned each year to bolster enrollment in the Affordable Care Act’s exchanges, funding a blitz of advertisements and grass-roots organizing. 

But President Trump is openly hostile to the law, and few expect that the latest sign-up period will receive heavy promotion from his administration. 

That’s leaving local groups, called navigators, to fill the gaps.

Navigators work on the ground to help people enroll in ObamaCare, guiding them through what can be a confusing process while conducting broader public outreach.

They are part of a larger “assister” program, comprised of different groups responsible for helping people enroll in healthcare; some of the groups get funding from the federal government.

“In the past, assisters and other community groups have partnered with the administration to get the word out. … They’re worried about how this will work if they aren’t in that partnership this year, if they’ll have to work on their own, and even more if they have to work against a negative message,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation in Washington, D.C., who studies navigators and other assister programs.

Alaska Primary Care Association is among the dozens of nonprofits and organizations that received a three-year grant from the federal government to help people sign up for health coverage locally. These “navigator” grants were first awarded in 2015. 

It’s widely expected that grants for navigators this year will be about $60 million, a decrease of $3 million from last year, Pollitz said.

The Trump administration has made no formal announcement about the grants, and CMS would not comment on whether they would continue. But more than a half dozen groups contacted by The Hill said all signs point to receiving the last round of funding in September. 

But the Trump administration has already pulled the plug on additional assistance, totaling $22 million, to 18 cities, saying those contracts were never meant to be long-term.  

It’s also unclear if Obama-era partnerships and campaigns with other major organizations, such as Uber and game streaming site Twitch, will continue, or if the administration will continue with advertising meant to encourage people to sign up. 

State and local navigator groups are planning rigorous outreach, but they’re facing another big challenge: A shortened enrollment period. The Trump administration cut the time people have to sign up for plans by half, leaving consumers with just 45 days to buy insurance on the exchanges. 

As a result, ad campaigns are starting earlier than ever before.

Community Council of Greater Dallas — which helps people enroll in Northwest Texas — ran its first advertisement in a local newspaper Aug. 15. That’s about a month earlier than in previous years, said Daniel Bouton, the council’s director of community health services.

Florida Covering Kids and Families is increasing its staffing to “address the needs of a lot of people who might need assistance in less time,” said Jodi Ray, director of the program, which is affiliated with the University of South Florida.

And in Missouri, an organization that is helping seniors across the state is starting its advertisements earlier and hitting the message of coverage harder.

“We’re not going to have the luxury of that time: So our message from the very beginning is going to be more the urgent message: Now’s the time,” said Catherine Edwards, the executive director of the Missouri Association of Area Agencies on Aging. 

“If you did sign up last year, review your plan. If you had not signed up, now’s the time. This is not a decision you can put off because this is a very short time frame.”

Assisters will also have to cut through confusion about the law because some may think it has been repealed.

“I’m getting reports from my team, my navigators — we’re seeing an increased number of calls and appointments over the last several weeks,” Ray said. “I think people were feeling confused about what’s going on. Some people don’t realize that the Affordable Care Act is still the law.”

It remains to be seen how much the Trump administration will do to encourage ObamaCare enrollment.

The administration recently spent money intended to encourage enrollment on videos that feature people who said they have been hurt by ObamaCare, according to the Daily Beast.

In addition, the administration hasn’t given any signals that it will continue partnerships with several groups that helped promote open enrollment, according to Talking Points Memo.

A CMS spokesperson said the agency has determined that it has the on-the-ground resources necessary in “key” exchange markets but would not elaborate.

The spokesperson noted that CMS operates a year-round exchange call center to help people with their enrollment needs.

The Arizona Alliance for Community Health Centers, the state’s largest recipient of the federal government’s navigator grant, said there are still questions about how the administration will handle open enrollment.

But its plan is to continue using best practices to find people and get them signed up for coverage.

“While the administration has been silent in a lot of areas, the right thing to do for consumers is to just stay engaged and keep moving forward like nothing is going to change,” said Allen Gjersvig, the alliance’s director of navigator and enrollment services.

Meanwhile, advocacy groups that spent the past six months fighting ObamaCare repeal are shifting some of their resources to driving up enrollment.

“We have a vast network of groups that have a lot of power in making sure people are aware of open enrollment and these options that are available to them,” said Angel Padilla of Indivisible, a grass-roots group formed after Trump’s election. 

“I think we recognize this fight to defend healthcare isn’t over.”