SALT LAKE CITY — Federal funding for Utah groups that help people sign up for health care on the federal exchange has been cut by 61 percent for the upcoming enrollment period, according to Utah Health Policy Project.
Federal officials have criticized the effectiveness of organizations working to enroll people under the Affordable Care Act, but Utah advocates say the Trump administration is not correctly measuring performance and is undermining the ACA.
In all, the grant from the U.S. Department of Health and Human Services is now a little more than $289,500, compared to $740,000 in 2016.
"I (was) expecting a cut, but not a slashing," said Randal Serr, director of Take Care Utah. "I've been kind of stunned for the last few hours trying to figure out what we're going to do next. It kind of puts us in a tough spot."
Jason Stevenson, Utah Health Policy Project spokesman, said the drastic drop in funding is a significant blow to his and other organizations' efforts to get people insured.
"We'll have to re-evaluate our staffing. It's hard to say exactly what that will entail," Stevenson said.
The Washington Post reported Thursday that similar organizations around the country also learned Thursday that their funding would be severely cut, including one by 92 percent. Nationwide, the total cut in grants was expected to be 40 percent, according to a previous Health and Human Services announcement.
Serr said he and others are reaching out to different organizations in an effort to make up for the lost funding, but couldn't provide further specifics.
"We're putting our feelers out to some of our close partners, but nothing concrete yet," he said.
Stevenson said while some of the funding goes to administration and marketing costs, the majority of it is dedicated to paying what the organization calls "navigators." The Utah Health Policy Project directly funds 16 navigators who search out uninsured people and instruct them on whether they're eligible for health insurance on the federal exchange, which federal premium subsidies they may qualify for and how to enroll.
The Utah Health Policy Project administers federal grants to the Take Care Utah network of nonprofits, of which it is a part and which also includes United Way 2-1-1 and Association for Utah Community Health, organizations that also promote enrollment.
Department of Health and Human Services officials announced late last month that there would be cuts, saying funding going toward 98 navigator organizations nationwide was not believed to be effective and that those organizations have enrolled less than 1 percent of the federal exchange total's recipients.
Department spokeswoman Caitlin Oakley said at the time that navigators would be granted funds "in proportion to their performance."
Stevenson said the Trump administration's use of official enrollee sign-ups as a metric doesn't account for all the work that navigator organizations do.
"That's an incomplete measure because there's a lot navigators do that is short of actually enrolling people but is critical," he said.
For example, he said, a person wouldn't be counted as a sign-up if the organization helps them enroll in Medicaid or CHIP after finding out they're eligible for one of those programs.
There are also heavy efforts in the state to follow up with people and ensure they are making their initial monthly premium payments, which keeps insurers paid and Utahns covered, Serr said.
Serr said that in surveying others' reduced grants around the country, it's become apparent to him that the cuts seem arbitrary, rather than tied to enrollment figures.
"This administration doesn't care about facts or figures or logic. ... They're just making cuts to funding based on logic that we don't understand," he said, adding that Take Care Utah organizations reached 75 percent of their enrollment goal.
Stevenson and Serr pointed to Utah's enrollment statistics in the latest sign-up period, showing that the state enrolled the most new people on the federal exchange out of the 39 states that use it, and gained the third-most new enrollees as a percentage of the state population.
By the end of open enrollment earlier this year, about 197,000 Utahns had health insurance on the federal exchange, approximately 21,500 more than a year earlier. Stevenson said that over the past year, navigators have officially enrolled 1,372 Utahns in health insurance plans on the federal exchange, and 2,003 people in Medicaid.
Navigators have also provided help to Utahns in the form of 228,825 phone calls or in-person interactions in that same time period, Stevenson said.
Take Care Utah’s navigators are still available to help by calling 2-1-1 or going to takecareutah.org