The Trump administration needs to take more steps to better manage ObamaCare after enrollment dropped by 5 percent in 2018, the nonpartisan Government Accountability Office (GAO) said in a critical report released Thursday.

The GAO recommended that the Department of Health and Human Services (HHS) set enrollment targets for 2019, a practice taken by the Obama administration but abandoned by the Trump administration, and better manage local groups responsible for signing people up for ObamaCare.

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Congressional Democrats who requested the report said its conclusions are proof the administration purposely set the Affordable Care Act (ACA) up for failure.

“This independent and nonpartisan GAO report confirms that the Trump Administration’s sabotage of our health care system is driving up costs for consumers and leaving more Americans without health insurance,” Rep. Frank Pallone Jr. Frank Joseph PallonePharma execs say FDA will not lower standards for coronavirus vaccine Dem chairmen urge CMS to prevent nursing homes from seizing stimulus payments Federal watchdog finds cybersecurity vulnerabilities in FCC systems MORE (D-N.J.) and Sens. Patty Murray (D-Wash.), Ron Wyden Ronald (Ron) Lee WydenHillicon Valley: Subpoenas for Facebook, Google and Twitter on the cards | Wray rebuffs mail-in voting conspiracies | Reps. raise mass surveillance concerns On The Money: Anxious Democrats push for vote on COVID-19 aid | Pelosi, Mnuchin ready to restart talks | Weekly jobless claims increase | Senate treads close to shutdown deadline Democratic senators ask inspector general to investigate IRS use of location tracking service MORE (D-Ore.) and Bob Casey Robert (Bob) Patrick CaseySecond GOP senator to quarantine after exposure to coronavirus GAO report finds brokers offered false info on coverage for pre-existing conditions Catholic group launches .7M campaign against Biden targeting swing-state voters MORE (D-Pa.) said in a statement.

“It’s not surprising that consumers were confused about the status of the ACA at the end of last year, which made the extreme cuts to consumer outreach and advertising that much more egregious.”

Most of the stakeholders interviewed by the GAO said consumer confusion about ObamaCare likely played a major role in the decline in enrollment.

While 9.2 million people signed up for ObamaCare plans in 2017, 8.7 million people enrolled in 2018.

Stakeholders also blamed the administration's decision to cut funds for outreach and advertising.

"Some stakeholders reported that outreach and advertising are especially important for increasing new enrollment, especially among younger and healthier consumers whose enrollment can help ensure the long-term stability of the exchanges," the GAO wrote.

However, other stakeholders said they thought the decision likely had no effect on enrollment since many consumers who need ObamaCare coverage are already well-aware of the program.

Some attributed confusion to Congress's multiple attempts to repeal and replace ObamaCare, and many blamed the Trump administration's negative comments about the health-care law.

Most stakeholders said the high cost of ObamaCare plans played "major role" in this year's enrollment.

In 2018, premiums across all healthcare.gov plans increased an average of 30 percent.

A big driver of these increases was the Trump administration's elimination of key ObamaCare insurer payments, the GAO notes.

The GAO made three recommendations to HHS, including that it should go back to establishing enrollment targets "to ensure it can monitor its performance."

HHS declined, arguing that it doesn't believe that enrollment targets are relevant to determine whether an open enrollment period is successful.

"Without establishing numeric enrollment targets for upcoming open enrollment periods, HHS’s ability to evaluate its performance and make informed decisions about how it should deploy its resources is limited," the GAO wrote.

"We also believe that these targets could help the agency meet its program objectives of stabilizing the market and of increasing the mix of younger and healthier consumers purchasing plans through the individual market."

The GAO was also critical of the administration's decision to reduce funding for local groups that sign people up for ObamaCare by 40 percent.

The administration took a different approach than the Obama administration in tying how much funding a group gets to how well it meets its enrollment goals.

But the data the administration used to determine funding was "problematic," the GAO said.

"Because HHS calculated awards using problematic data, navigator organizations may have received awards that did not accurately reflect their performance in enrolling individuals in exchange plans," the GAO said.