Obamacare Outreach Cuts Could Reduce Enrollment by 1.1 Million

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By Sara Hansard

At least 1.1 million fewer people are likely to enroll in Obamacare health insurance plans in 2018 because of a 90 percent cut in outreach funding made by the Trump administration, a former Obama administration official said Oct. 23.

There are many variables in estimating the number of enrollees, Josh Peck, who was chief marketing officer of the Health Insurance Marketplace in the Obama administration, told Bloomberg Law. But enrollment could end up at about 11.1 million for 2018, compared with 12.2 million enrollees for 2017, he said. The Trump administration cut funding for Obamacare outreach, including television ads, from $100 million to $10 million. Advertising and outreach activities will be targeted to informing consumers about the shorter open enrollment dates through digital media, email, and text messages.

The open enrollment period, scheduled for Nov. 1 through Dec. 15, could be headed for chaos, as many people who might have signed up are unaware of the new deadline, and some people believe congressional Republicans succeeded in repealing the law. Health insurers and groups that support the Affordable Care Act argue that the funding cuts will make it that much harder to reach potential enrollees.

Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.) are also working on bipartisan legislation that would provide funding for cost-sharing reductions and give states more flexibility to get waivers under the ACA. But it isn’t clear whether the bill will pass, or when.

Ad Campaigns Haven’t Delivered Gains

“As Obamacare enters its fifth open enrollment period, it is clear that massive advertising campaigns have not delivered substantial gains in coverage on Obamacare’s exchanges,” Department of Health and Human Services spokesman Matt Lloyd told Bloomberg Law in an email Oct. 23.

Americans bought fewer exchange plans for 2017 despite an advertising budget that was nearly doubled by the Obama administration to about $100 million, according to background information provided by the HHS. “More marketing will not convince Americans to sign up for failed coverage they cannot afford or that does not meet their needs,” Lloyd said.

The $10 million the Centers for Medicare & Medicaid Services plans to spend on ads is consistent with promotional spending on Medicare Advantage and Medicaid Part D, the HHS said. About 41.3 million people enrolled in Part D drug plans and 19.1 million enrolled in Medicare Advantage plans, the agency said.

Larger Enrollment Cuts Likely

The cuts in enrollment are likely to be larger than the 1.1 million estimate, Peck said. The $90 million cut from the 2018 outreach budget by the Trump administration doesn’t include cuts for in-person assistance from the ACA navigator program, or an executive order issued Oct. 12 by President Donald Trump announcing upcoming changes to the law’s regulations, he said.

Cutting television advertising will be particularly harmful to the enrollment effort, Peck said. The 12 states that operate their own state-based marketplaces, which includes the District of Columbia, may have their own advertising budgets and may not be hurt as badly, he said. But in the 39 states using the federal HealthCare.gov website, funds for television advertising are likely to be slim, he said.

The advertising budget also includes search ads for internet sites such as Google, which are crucial to the enrollment effort, Peck said. “The budget for search ads last year was much larger than the entire budget they have for outreach this year,” he said.

To contact the reporter on this story: Sara Hansard at shansard@bna.com

To contact the editor responsible for this story: Kendra Casey Plank at kcasey@bna.com

For More Information

Josh Peck's analysis, Trump’s ad cuts will cost a minimum of 1.1 million Obamacare enrollments, is at http://src.bna.com/tBb.Policies Related to the Navigator Program and Enrollment Education for the Upcoming Enrollment Period is at http://src.bna.com/tBd.Draft legislation to stabilize individual market premiums for the 2018 and 2019 plan years is at http://src.bna.com/tBb.Information on President Trump's Oct. 12 executive order is at http://src.bna.com/tBv.

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