Letter to Seema Verma, Centers for Medicare and Medicaid Services - Reinstate Funding For Program to Connect Ohioans with Healthcare

Letter

Dear Administrator Verma:

We write regarding our concerns over the Centers for Medicare and Medicaid Services' (CMS) recent actions involving the Affordable Care Act's Navigator program, which have caused uncertainty and significant confusion in communities across the country. The result is that fewer Americans will learn about available insurance options and how to enroll for the 2018 plan year. CMS must act swiftly to re-instate the scheduled 2017-2018 funding, and to clarify the basis for any changes to the previously pledged funding of the Navigator program.

The ACA Navigator program is a lifeline for many Americans seeking affordable, quality health insurance. Navigators assist countless citizens seeking to learn about and sign up for health insurance, including individuals with disabilities, young adults, enrollees who do not speak English, citizens who move to a new state, and those who enroll in Medicaid for the first time. Because they often represent local non-profit organizations, Navigators are trusted community resources who are well suited to provide information about what can be a difficult and confusing process.

Businesses and non-profits need certainty and predictability in order to operate effectively. Unfortunately, CMS's August 31, 2017 announcement that it was changing the funding and structure for the Navigator program undermined the certainty that consumers, Navigators, and insurers require. Compounding this uncertainty was CMS's failure, for over a week, to provide any additional information to grantees about these potential cuts. This unexpected change, accompanied by limited follow-up and no additional context or information, has created significant insecurity among grantees and sent many Navigators into a panic, with less than two months to go until this fall's abbreviated open enrollment period. CMS's failure to release the expected funding for Navigator programs on September 2, 2017 further compounded this insecurity. Two weeks after its original announcement, CMS finally provided additional information and delayed funding to individual grantees on September 14, 2017.

These actions, taken together, have impeded Navigator programs as they assist with health coverage for our nation's most vulnerable citizens. They have created an environment of instability, producing immediate consequences -- from canceled appointments and events, to the laying off highly skilled staff. States and organizations that have been targeted with particularly unreasonable cuts despite a record of strong enrollment success, such as at the Ohio Association of Foodbanks (-71%) and Covering Wisconsin (-42%), are left asking if their programs are even sustainable. What is more, CMS provided no information outlining how these cuts were calculated.

Furthermore, HHS's requirement that the Navigator programs submit a new budget and work plan within two weeks, including restrictions on reimbursement for the first two weeks of the year when programs had no funding, is excessive and unnecessary. Ripping the rug out from these programs and then requiring additional work on a shoestring budget during their preparation for the most important time of the year is inexcusable and appears to be little more than conscious sabotage. Playing games with the stability of the ACA will drive down enrollment and lead to higher health coverage costs, while causing additional job loss along the way.

We encourage CMS to act immediately to re-instate full funding for the Navigator program for 2017-2018 plan year, including appropriate retroactive funding for the time that has passed since September 2, 2017. Furthermore, we encourage CMS to provide a detailed explanation and review to these Navigator programs with a comprehensive rationale for the recent cuts, as well as any changes in funding that will take place during this new fiscal year that has already begun.

We appreciate your full attention and responsiveness to this urgent and important matter, and look forward to learning more about your plan to rectify this serious situation and ensure quality, comprehensive enrollment assistance across all communities throughout the entire plan year.