- The Washington Times - Thursday, August 23, 2018

The Trump administration undercut Obamacare by failing to set enrollment targets and stopping ads to remind customers to sign up, the government’s chief watchdog said Thursday in a report saying that more damage is looming unless the administration changes course.

Without a clear yardstick for sign-ups, the government can’t make plans for how to keep current customers and win new ones, particularly among the young and healthy people needed to make the 2010 law’s economics work, said the Government Accountability Office.

Investigators also questioned the Health and Human Services Department’s decision to slash the TV promotion budget for HealthCare.gov, the federal sign-up portal, from $26 million in 2017 to zilch in 2018.

The administration said the ads were too expensive and didn’t entice young people, but the GAO said the agency’s own evidence suggests they were a vital tool.

“A 2017 HHS study found this was one of the most effective forms of paid advertising for enrolling new and returning individuals during the prior open enrollment period,” investigators said in the report.



Democrats said the audit is firm proof to back up their longstanding claims that President Trump and his team have sabotaged Obamacare, leaving Americans struggling to find affordable insurance.

“This report should serve as a wake-up call to the Trump administration that it needs to change course when it comes to educating and notifying millions of Americans about their health care options for 2019,” said four senior Democrats on House and Senate committees.

Mr. Trump and his GOP allies tried to wipe President Obama’s signature law off the books last year, but the effort faced grass-roots outrage and sputtered out of gas by the fall, leaving the administration to implement a program it views as unworkable.

Democrats say the administration, through a mixture of apathy and antipathy, is chasing and cajoling customers out of Obamacare by approving substandard plans and alternative means of obtaining coverage.

The administration says it’s trying to maximize its dollars and to push plans that match most consumers’ needs.

Sign-ups on HealthCare.gov dipped slightly in Mr. Trump’s first year in charge, from 9.2 million in 2017 to 8.7 million. The administration said that was a solid showing in the face of rising premiums, and customers seemed satisfied by the sign-up process.

“These figures show that while HHS spent less on outreach and advertising, enrollment stayed essentially the same as the previous year,” said Matthew Bassett, assistant HHS secretary for legislation, to the GAO.

The GAO did give the administration credit for slashing wait times at call centers and keeping HealthCare.gov online without the glitches that affected the program’s early years.

Yet other actions were disruptive or yielded mixed results, the GAO found.

Mr. Trump’s decision to cancel “cost-sharing” payments to insurers resulted in higher premiums. Many states loaded those increases onto so-called silver plans that determine federal subsidies for customers with low enough incomes.

Higher rates mean higher subsidies, so the 85 percent of customers who received assistance in 2018 often found better deals.

Unsubsidized customers, though, looked outside of Obamacare’s exchanges, resulting in lower sign-up tallies for Mr. Obama’s program.

“Most stakeholders we interviewed told us the decreased affordability of plans likely resulted in lower enrollment in exchange plans for these consumers,” the GAO said.

The GAO also said HHS used faulty data in deciding to how dole out grant funding in-person assisters, or “navigators,” who help people sign up.

The administration slashed 2018 funding by 42 percent, saying groups would be tightly judged on whether they met their enrollment targets in previous years.

Yet navigator groups didn’t always put their ID numbers into the web program in prior years, which tracks their imprint on the process, and some couldn’t enter it anyway, because an insurance broker already took up the space — leaving the government to make judgments on incomplete data.

HHS said it is working on the web glitches and said navigator funding will be tied to “self-identified goals and their ability to meet those goals.”

But the department dug in on enrollment targets, saying too many factors affect sign-ups for the government to be able to set strict goals. It said its goal is to make HealthCare.gov work for those who want to use it.

“HHS believes a more informative performance metric is whether everyone who utilized Healthcare.gov, who qualified for coverage, and who desired to purchase coverage, was able to make a plan selection,” Mr. Bassett wrote.

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