In the fight to preserve the Affordable Care Act (ACA, or Obamacare) and provide equitable and accessible health care for all Americans, there are no lasting victories. As we learned in the spring and summer, for every plot by Congressional Republican leadership and the Trump Administration to strip tens of millions of people of health insurance that is foiled by health care advocates, a new one inevitably pops up in its place. Thus, when the extremist Graham-Cassidy health care legislation failed to make it to the Senate floor for a vote last week, HIV advocates and all our friends in the battle for a more just and affordable health care system knew our celebration would only be temporary.
With his Plan A of repealing and replacing the ACA on hold for the moment while the Congressional GOP licks their wounds and plans their next legislative attack, the Trump Administration has turned to what has always been their Plan B: sabotage. Less than a week after being sworn in, President Trump was already laying the groundwork for a broad and systemic undermining of the ACA and, as the months have gone on and the failures to repeal President Obama’s signature legislative achievement have multiplied, so too have the Trump Administration’s efforts to destroy it from the inside out.
In a bold-faced attempt to sabotage the ACA, the Trump Administration has shortened the ACA open enrollment period by half—only running it from November 1st through December 15th as opposed to the customary November 1st through January 31st timeline, cut the advertising budget for open enrollment by 90% and reduced funding for the insurance navigator groups that help people through the often complicated enrollment process from $62.5 million to $36.8 million, with some navigators losing up to 90% of their funding. Along with these funding cuts and the shortened enrollment period, the Trump Administration has in recent weeks announced that they will be shutting down healthcare.gov from midnight to noon on 5 of the 6 Sundays during the open enrollment period and, very quietly, revealed that the Department of Health and Human Services would not be doing any of their traditional ACA marketplace coordination events in the South this year.
By reducing the open enrollment period from its traditional 90 days to fewer than 45 days and doing everything in their power to deny potential marketplace enrollees of technical assistance while actively blocking efforts to alert the general public to its existence, the Trump Administration is trying to kill the ACA not with one traumatic blow, but with a thousand little cuts. It is up to us as HIV and health care advocates to ensure that ACA marketplaces survive and thrive as they were meant to. This will certainly not be an easy task, but we don’t have to do it alone. As they have all along, our allies across the health care advocacy spectrum will rise to the challenge with us and, together, we will counteract the malicious designs of the Trump Administration.
Granted, this is easier said than done, but there are a number of resources already available to aide us in navigating through what will be a very difficult open enrollment period. Perhaps the most promising of these resources is a new organization called Get America Covered. This organization, which was founded by two former Obama administration officials who helped orchestrate outreach and education efforts for past open enrollment periods, is designed to fill in the informational gaps that have been left by massive cuts to advertising and outreach budgets.
Get America Covered just launched earlier this week and they only have a six-figure budget, so the amount of content they’ve been able to produce so far isn’t very large. However, we encourage you to go sign up for their alerts, follow them on Facebook and Twitter, share their ACA enrollment fact sheet, and utilize their social media resource page to help spread the word about their efforts.
For our part, AIDS United will be doing our best to keep you up to date on all the latest developments regarding ACA open enrollment and will also be working hard to link as many people living with HIV to care as we possibly can through our own education, outreach and technical assistance. It won’t be easy, but we will work together to thwart the sabotage of the Trump Administration and make sure that those who seek care on the ACA marketplaces are able to find it.