The Trump administration’s move to cut funding for people who help consumers buy individual health insurance plans should not affect Oregon, state officials said, as the state funds its own enrollment assistant program.
The Oregon Health Insurance Marketplace provides grants to community groups and local insurance agents — often called navigators — to help people enroll in health coverage and access subsidies available under the Affordable Care Act. Additionally, community groups that receive funding to enroll people in the Oregon Health Plan are also cross-trained in marketplace enrollment assistance, and insurance agents can get training directly from HealthCare.gov.
During the open enrollment period for 2018, 45,953 Oregonians received help from such assistance groups, representing nearly 30 percent of the total number of people who enrolled.
Four insurance agencies in Central Oregon — Country Financial, Bancorp Insurance, High Desert Insurance and Central Financial Services of Oregon — are receiving grants this year. But so far, no Central Oregon community groups have applied for the funding.
Last week, the federal Centers for Medicare & Medicaid Services announced navigator funding for the 2019 open enrollment period at the end of this year would be cut by 70 percent from $46 million to $10 million. That’s on top of a 40 percent cut in the previous year.
CMS officials said that as the exchange enters its sixth open enrollment period, less help is required than in the initial years of the ACA.
“As the exchange has grown in visibility and become more familiar to Americans seeking health insurance, the need for federally funded navigators has diminished,” the agency said in a statement announcing the cuts.
CMS said it would encourage those seeking the funds to demonstrate how they would provide information not just about exchange plans, but the wider range of plans now available to consumers, including association health plans, short-term, limited duration insurance and health reimbursement arrangements.
Critics, however, blasted the move as another attempt to undermine the ACA, commonly called Obamacare. The short-term plans that the Trump administration approved earlier this year have been criticized as “junk plans” that offer incomplete coverage. Those plans could also set higher premiums for women and older people, while excluding coverage for pre-existing conditions. Many have warned those plans could attract healthier patients, leaving exchange plans with sicker, higher cost patients. In the long run, that could drive health insurance premiums even higher.
U.S. Sen. Ron Wyden, D-Ore., said the move to have navigators advocate for short-term plans amounts to “federally funded fraud.”
“Paying groups to sell unsuspecting Americans on junk plans that allow insurance companies to deny care on a whim and charge whatever they want is nothing but a scam,” the senator said. “Trump’s sabotage crusade is making it harder and harder for families to afford quality insurance that isn’t filled with loopholes and exceptions that benefit insurance companies.”
—Reporter: 541-633-2162, firstname.lastname@example.org