Nonprofit groups tasked with Obamacare outreach had to rely on partnerships and donations to make up for the Trump administration's nearly 40 percent cut to funding for the 2018 open enrollment season.

The Trump administration cut the navigator funding by nearly 40 percent last year because of concerns that the groups didn’t enroll enough people, and pointed to some navigators that only signed up a handful of people for 2017 coverage. The groups are required to not only provide help with Obamacare but other types of health outreach, such as helping people determine if they are eligible for Medicaid and helping enrollees find out if their doctor is in their network.

Georgetown University’s Center on Health Insurance Reforms talked to 14 navigators to determine how they fared during the 2018 open enrollment session that ended on Dec. 15, a full six weeks earlier than the 2017 open enrollment period.

So far, 8.8 million people signed up for Obamacare through healthcare.gov, which is used by residents in 39 states. That figure, which does not include totals from 11 state-run exchanges, is only slightly below the 9.2 million that signed up for 2017 coverage.

Navigators told the university they relied on partnerships they had developed in previous years to help get the work done in light of the funding cut. For instance, the navigator Get Covered Mississippi worked with head start centers to make sure entire families got coverage.

Some navigators joined community events such as church or library meetings because they did not conduct their own stand-alone outreach events, Georgetown’s report said.

“They targeted middle- to low-income areas where they were likely to find more people who would qualify for subsidies and prioritized cities and big towns over less populous communities to reach more people in a shorter time,” the report said.

Other navigators got in-kind donations of free radio time or low-cost ads to make up for the loss in outreach funding.

In addition to the 40 percent funding cut, the Trump administration cut Obamacare ad funding by 90 percent compared to 2017. The administration only spent $10 million for 2018 on ads compared to $100 million in 2017.

The 14 navigators reported that the shoestring efforts paid off as enrollment for 2018 was between 92-98 percent of 2017 enrollment. However, organizations in vastly rural areas like Georgia or Montana had to cut back on the number of counties they could serve, the report added.

“In other states, like New Jersey and Virginia, prioritizing low income communities meant less outreach to higher-income communities that have concentrations of eligible uninsured people,” Georgetown University said. “The organizations we spoke to worried about the people they missed and the regions they could not serve, an absence that experts believe fell disproportionately on African-American and Latino communities.”