Trump administration slashes ACA navigator funding
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The Trump administration is cutting funding for navigators, who help people sign up for Affordable Care Act coverage, by almost 90%, the Centers for Medicare and Medicaid Services announced Friday.
Why it matters: CMS says the savings will help it focus on more effective strategies on the federal marketplace exchanges and reduce premiums for people who do not qualify for ACA premium subsidies.
State of play: Insurance navigators will now receive $10 million per year over the next five years, CMS said.
- Navigators received $98 million in federal funding during the 2024 plan year.
- Unlike insurance agents and brokers, navigators cannot be paid by insurance companies and don't recommend specific plans or policies to consumers. They provide overviews of plans and financial assistance available to consumers.
Flash back: The first Trump administration also cut navigator funding to $10 million per year.
- The Biden administration put money back into navigator grants, and last year announced a plan to devote $500 million for the effort over five years.
Zoom in: Navigators enrolled 92,000 consumers, or 0.6% of plan selections, in the federal health insurance exchange for the 2024 plan year. That's a similar percentage to 2019 when they received far less funding, CMS said.
Yes, but: Federal data shows that navigators also enrolled more than 290,000 people in Medicaid and the Children's Health Insurance Program last year.
The other side: "Insurance brokers have become an important source of ACA signups, but navigators are particularly effective in low-income communities, helping people enroll in Medicaid as well," Larry Levitt, executive vice president for health policy at KFF, told Axios.
What we're watching: A proposal on ACA plan program integrity this week became the first CMS regulation to make it to the White House for review during the second Trump administration.
- There are no details yet on what the proposal includes, but a recent report from by Peter Nelson, new director of CMS's Center for Consumer Information and Insurance Oversight, could offer clues.
- It takes issue with Biden-era ACA changes expected to increase federal expenditures, including a permanent special enrollment period for lower-income consumers.
