As Trump Alters Affordable Care Act, Programs To Aid, Enroll Users Are Cut

Washington is slashing funding to "navigator" programs that enroll people in health insurance under the Affordable Care Act. Some are being closed entirely, just weeks ahead of the enrollment period.

RENEE MONTAGNE, HOST:

With Republican lawmakers unable to repeal and replace the Affordable Care Act, President Trump has taken several steps to undo it. Just before the weekend, he refused to pay the subsidies to insurers that helped keep premiums down for low-income people. And, also, the administration is cutting funding for outreach to those who want to sign up when open enrollment begins next month. The Affordable Care Act provides money to organizations that help people navigate the health care system. In fact, they're called navigator programs. Last year, they received $63 million from the government. The Trump administration has cut that funding by 41 percent. I'm joined by Lisa Hamler-Fugitt, she's executive director of the Ohio Association of Food Banks, which oversees a navigator program. Welcome.

LISA HAMLER-FUGITT: Thank you.

MONTAGNE: And your program's budget was reduced by how much?

HAMLER-FUGITT: Seventy one percent - nearly $1.2 million dollars. And it was a significant reduction.

MONTAGNE: A significant reduction. So what was the money paying for?

HAMLER-FUGITT: We hired 54 navigators that worked in all areas of the state - both urban and rural areas - hard-to-reach communities that were providing unbiased information that allowed individuals to make the appropriate choices about health care for themselves and their families.

MONTAGNE: And the Trump administration has said that some of these many navigator programs were failing to meet their targets, that they were going to put the largest reductions on to the groups that weren't performing. How does that apply to you?

HAMLER-FUGITT: It does not apply to the Ohio Association of Food Banks and our consortia partners. We have served for four years to carry out navigator activities in the state of Ohio. And for those four years, we have met, nearly met or exceeded all of our deliverables. All of the feedback that we had received was very positive - keep up the great work. We certainly wish other states would perform to your level and standards. I believe at one point they even said that we were, quote, "rock stars."

MONTAGNE: So I can - may I presume that you were shocked?

HAMLER-FUGITT: Shocked would be an understatement, but really deeply, deeply and profoundly disappointed and felt as though, quite frankly, we were being held hostage in the belief that it was really - appeared to be a political maneuver to damage the viability and stability of the Affordable Care Act. And at that point, our members voted unanimously to terminate our contract on navigator services in Ohio.

MONTAGNE: Well, one thing - the administration has argued that there are fewer people signing up under the exchanges. Is there, in fact, really the same need as there was when the law first went into effect? I mean, are you seeing - have you been seeing fewer people sign up over the years?

HAMLER-FUGITT: No. No. And quite the opposite, in fact. Since inception, and the enrollments continue to go up, we - nearly a million Ohioans have gained access. So what the Trump administration has stated is clearly not the experiences that we had and continue to have in the state of Ohio.

MONTAGNE: That's Lisa Hamler-Fugitt. She's executive director of the Ohio Association of Food Banks. Thanks very much for joining us.

HAMLER-FUGITT: Thank you so much.

(SOUNDBITE OF KHALID SONG, "LOCATION (EYESLOW TRAP REMIX)")

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.