Levin to Verma: Explain ACA Outreach Cuts

Sep 8, 2017 Issues: Health Care

WASHINGTON, DC – Rep. Sander Levin (MI-09), Ways and Means Subcommittee on Health Ranking Member, today sent the following letter to CMS Administrator Seema Verma regarding the 2018 budgets for Affordable Care Act (ACA) Navigator organizations. A Centers for Medicare and Medicaid Services (CMS) bulletin released August 31 indicated that funding for advertising and educational activities will be subject to a 90 percent cut, with additional cuts for Navigator organizations.

“Based on conversations my staff has had with Navigators in Michigan, this is creating confusion and hindering their ability to plan for the next Open Enrollment Period, which begins on November 1st,” wrote Rep. Levin. “Further, news reports indicate that CMS’s failure to provide funding to Navigator organizations is having an immediate negative impact, with some Navigators finding themselves forced to lay off experienced staff, cancel planned community outreach events, and postpone appointments with consumers who qualify for a special enrollment period or who need assistance enrolling in a Medicaid plan.

A PDF version of the letter is available online, and the text is below.

September 8, 2017

Seema Verma
Administrator
Centers for Medicare and Medicaid Services
Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington, DC 20201

Dear Administrator Verma:

I am deeply troubled by an August 31st, 2017 bulletin released by the Centers for Medicare and Medicaid Services (CMS) announcing cuts to important programs that support enrollment in Marketplace coverage under the Affordable Care Act (ACA). The bulletin states that funding for advertising and educational activities will be subject to a 90 percent cut, while Navigator organizations will be subject to a new funding methodology that could reduce grant funding by approximately 40 percent. This announcement comes only weeks before this year’s Open Enrollment Period, creating tremendous uncertainty at a critical moment.

Cuts to Navigators will be particularly harmful to the people of my home state of Michigan. Since passage of the ACA, thousands of Michiganders have benefited from in-person assistance, phone counseling, and other important services provided by Navigator organizations. These programs have expanded access to coverage to vulnerable populations, individuals with disabilities, and young adults, many of whom would otherwise be uninsured without the assistance of Navigators.

CMS’s unexpected announcement was inconsistent with previous statements by federal officials. Navigators report that they have yet to receive clarification regarding the extent to which expected funding will be available for the coming year. Based on conversations my staff has had with Navigators in Michigan, this is creating confusion and hindering their ability to plan for the next Open Enrollment Period, which begins on November 1st. Further, news reports indicate that CMS’s failure to provide funding to Navigator organizations is having an immediate negative impact, with some Navigators finding themselves forced to lay off experienced staff, cancel planned community outreach events, and postpone appointments with consumers who qualify for a special enrollment period or who need assistance enrolling in a Medicaid plan.

Due to the importance of this matter to my constituents and to health care consumers across the country, I request your response to the following questions:                                                                    

  • Will you provide an empirical justification for the new methodology for determining funding, including a clear link to how it is projected to impact enrollment in Marketplace coverage?
  • Can you provide projections of the impact of the cut in navigator funding combined with the near elimination of funding for advertising and educational activities?
  • When does CMS intend to notify Navigator organizations of the specific changes to their grants for the coming year, including a clear explanation of the extent to which their funding will decrease?
  • Navigator grants for 2016-17 ran through September 1st, but have not yet been announced for the current year. Will grants be backdated to September 2nd to ensure Navigators receive funding during the period in between the end of the 2016-17 grant year and the commencement of the 2017-18 grant year?
  • Will Navigators be permitted to utilize unspent funds from the 2016-17 grant year in support of this year’s enrollment activities?

Thank you for your attention to this urgent matter.

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