Health reform implementation

Trump cuts to ObamaCare outreach to hit red states most

The Trump administration’s decision to slash outreach funding for ObamaCare will hit red states the hardest.

The move last month to cut 90 percent of funds to spur signups for healthcare.gov is likely to lead to fewer young and healthy people in the insurance pool — and thus higher costs in states with majority Trump voters, according to experts.

But Trump has been threatening to let ObamaCare implode for months and has not shouldered much blame for the consequences of that uncertainty, including high premiums and lack of insurers in some markets.

{mosads}“Trump is not going to get blamed for this,” Republican strategist Ford O’Connell said. “The problems with ObamaCare need to be fixed, and it needs to be done by Congress.”

Late last month, in the latest sign of the Trump’s distaste of the law, Department of Health and Human Services officials said funding for advertising and other outreach for ObamaCare enrollment would be cut from $100 million last year to $10 million this year.

“Most of America is in healthcare.gov and it’s mostly all red states, and folks in those states are at risk of losing their opportunity, or not getting their opportunity to sign up” for health care, said Karen Pollitz, a Kaiser Family Foundation senior fellow.

Some 39 states rely on the federal government and federal insurance exchange in some form; 90 percent of those are Republican-majority states, according to Kaiser.

But even if Trump is immune, state officials are not happy.

Alaska Insurance Director Lori Wing-Heier told lawmakers recently that rural states like hers don’t have the infrastructure to do their own advertising and outreach.

With the funding cut, “we are very concerned it will have a major impact on enrollment,” she said at a Senate Health Committee meeting. “This will be devastating to our population.”

Trump won Alaska by 13 percentage points.

States don’t have nearly the amount of resources as the federal government. So even states with Democratic governors, or Republican governors critical of Trump, don’t spend their own money on advertising and promotion if they use the federal exchange.

“Recent actions to reduce funding that would drive individuals to sign up for insurance is penny wise and pound foolish,” Montana Gov. Steve Bullock (D) told the Senate Health Committee last week.

Montana officials contacted by The Hill said there are no plans to use taxpayer dollars to fill the gap left by the federal funding cuts.

Ohio Gov. John Kasich (R) is working on a bipartisan plan to stabilize ObamaCare and is seen as an anti-Trump Republican front-runner for the 2020 presidential race.

During a recent event in Washington, Kasich said he disagrees with the advertising cuts.

“I’m not keen on that. I wouldn’t make those kinds of cuts,” Kasich said, calling it a “bad idea.”

Ohio state officials didn’t return a request for comment on whether the state would commit its own money to promoting outreach efforts.

Although Kasich has been a strident Trump critic, the president won his state by 13 percentage states.

Pennsylvania is one exception. The state uses the federal exchange, but the Democratic governor is working with the insurance commissioner on a massive outreach campaign that will launch in October.

But conservatives are downplaying any negative consequences from the outreach and advertising cuts.

Health and Human Services officials said people already know about ObamaCare and the exchanges.

GOP policy analyst Chris Jacobs said coverage is too expensive, so reminding people to buy insurance that they can’t afford isn’t going to help. 

“So the federal government has to spend over $100 million in taxpayer dollars to nag people to buy coverage — even though people will be taxed if they don’t purchase it?” Jacobs wrote in an email.

“If that’s not the definition of an unpopular law, then I don’t know what is.”

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