Thread by @CitizenCohn

Still thinking about the massive cut to ACA navigator funding that the Trump administration announced on Tuesday.

It's not the most consequential act of sabotage we've seen. But it is among the most revealing. (1)

huffingtonpost.com/entry/trump-ob…

Trump officials say they are just trying to spend government money more wisely -- that the navigators aren't a worthwhile investment, because only a tiny fraction of people who enroll in marketplace coverage sign up through them. (2)

But the program cost less than $40 million last year. In the context of federal spending on health care, that is nothing. Not even a rounding error.

And the point of the navigators isn't to run up huge enrollment numbers. It's to provide assistance to people who need it. (3)

If you go to an open enrollment event, you'll see counselors working with clients intensely, sometimes for 20 or 30 minutes.

Many clients end up enrolling in Medicaid or CHIP, having discovered they are eligible. Or they take material home, ponder, and enroll online later. (4)

These people don't show up in the statistics that the Trump administration is circulating in order to justify the funding cut.

But these are the people find the enrollment process most daunting and, in many cases, stand to benefit most from getting access to health care. (5)

So, you may wonder, does the Trump administration have an alternative way of helping these people?

Of course not. (6)

Instead, they want to rely more on brokers, who don't have the time (and, in some cases, expertise) for cases like these. Also, the administration wants to steer people to plans that don't live up to ACA standards. (7) huffingtonpost.com/entry/gop-heal…

These plans aren't typically available to people with pre-existing conditions. And they leave out key benefits, which means you're in big trouble if you get sick.

Many don't even cover prescriptions, for example. kff.org/health-reform/… (8)

Note that, unlike some other instances of sabotage, this isn't even an attempt to destabilize the program. It won't affect risk pools, etc.

It will simply mean less help for people who need it.

Decide for yourself why the administration is doing this. (9)

* To be clear, in that last tweet, I'm referring to the navigator cut only. It won't do much to the risk pools. Clearing the way for short-term plans more generally, as the Trump administration is about to do, will definitely affect the risk pools -- and maybe in a big way. (10)