The Centers for Medicare and Medicaid Services, the federal agency that oversees ACA funding, said in a statement that navigators are inefficient, signing up a fraction of all ACA customers, and unnecessary as the ACA enters its sixth year and the public is increasingly familiar with health insurance. Many of those are self-employed people and small-business owners, generally seen as a Republican constituency.
America's Health Insurance Plans (AHIP), a trade group representing insurers offering plans via employers, through government programs and in the individual marketplace, said the CMS suspension would create a "new market disruption" at a "critical time" when insurers are setting premiums for next year. Unlike with other ObamaCare subsidy programs, risk adjustment payments shuffle money from insurers with relatively healthy populations to others.
The president last fall issued an executive order to try to make it easier for individuals and small businesses to buy health plans that cost less than ACA coverage because they cover fewer services and bypass rules meant to protect people from previous practices in which insurers charged higher prices to women, older people and those with pre-existing medical conditions. The ACA also prohibits insurers from rejecting applicants with pre-existing conditions and from charging older people exorbitantly high rates because they are higher financial risks.
This time, the agency which conducts the medical insurance markets is slashing funds for organizations which assist individuals to search for the policy, forcing the classes to make do with roughly one-fourth of the national funding they obtained to this year's open enrollment.
The administration argued in its announcement that its hands were tied by conflicting court rulings in New Mexico and MA.
Navigators will be "encouraged to demonstrate how they provide information to people who may be unaware of the range of available coverage options in addition to qualified health plans, such as association health plans, short-term, limited-duration insurance and health reimbursement arrangements", the CMS statement said.
This past year, navigators only received $36 million in funding, down from $63 million in 2016. Close to half get subsidized private coverage that would be affected by Saturday's Trump administration announcement. The mandate requires people without insurance from their employer or a government program to obtain health coverage or pay a penalty. John McCain, R-Ariz., cast a crucial "no" vote, with a thumbs down gesture that's become a target of Trump criticism at campaign-style rallies.
Navigators have been on the forefront on ACA enrollment for five years in North Carolina.
Signaling the administration's long-term objectives, Andrew Bremberg, who oversees domestic policy at the White House, told reporters a year ago, "The president still firmly believes that Congress must act to repeal and replace Obamacare, but before that can be done, this administration must act to provide relief".