The Navigator Nightmare—Why the Biden Administration Should Reject Wasteful Health Care Spending
It’s difficult at times to remember how the world was before COVID-19, but let’s take a break from 2020/2021 and look back for a moment in 2013—the year of the ObamaCare rollout. At that time, a line item of more than $100 million found its way into the budget for federal marketplace spending. These funds were for health care “navigators,” designed to sign people up for ObamaCare.
Here’s how it worked: The Obama administration doled out millions to their favorite community organizations so they could employ individuals to sign up individuals for the program. Perhaps best described as a “slush fund for progressive constituent groups,” these navigators raked up unfathomable bills—and were taken aback when critics dared to inquire as to whether this was a good use of taxpayer resources.
What kind of bills are we talking about? In the 2016 open enrollment, 17 navigators enrolled 100 people each at the cost of $5,000 per enrollee. One navigator grant recipient received $200,000 in taxpayer dollars to enroll just one individual. Meanwhile, 78 percent of navigators failed to achieve their enrollment goal. Tens of millions of dollars were flushed down the drain of government waste to prop up an unsustainable health care bureaucracy and funnel resources to favored groups.
This appeared to be a favorable arrangement for proponents of ObamaCare. In 2017 and 2018, the Centers for Medicare and Medicaid Services (CMS) pointed out this abuse of taxpayer dollars, and proceeded to reduce navigator spending and base remaining navigator grants on actual performance. Liberal activists cried foul, claiming this was a secret attempt to rob Americans of their health care. Chief among their claims was that these cuts would result in diminished enrollment in ObamaCare.
But here’s the truth: ObamaCare enrollment drops preceded navigator spending cuts. Even in 2016—when CMS doubled its spending on promotional activities for ObamaCare—there was a 42 percent decline among first-time enrollees.
ObamaCare enrollment seems to remain insulated from navigator spending. In 2017, navigators received $63 million—and enrolled fewer than one percent of ObamaCare participants. In 2018, navigators received $36 million—and still enrolled fewer than one percent of ObamaCare participants. There’s a pattern: No matter the spending on navigators, enrollment doesn’t really change, and the proportion of enrollees that navigators get on the program remains inexcusably low. It makes one wonder what these community groups were really doing with all that money.
In quite the contrast to navigators, independent brokers and agents helped enroll 42 percent of ObamaCare participants in 2018, at a cost of just $2.40 per enrollee—a stark difference from the hundreds or thousands of dollars per enrollee received by navigators.
Thankfully, federal spending on navigators has declined by more than 75 percent since 2016. Indeed, and perhaps ironically, the rate of decrease among participants in the individual market has actually slowed since navigator spending was reined-in, contrary to the predictions of liberal think tanks.
Yet, progressive groups are unsurprisingly re-upping their pleas for the Biden administration to increase “outreach” spending and expand the navigator program back to the bloated budgets under the Obama administration.
If there’s one thing we can all get behind in health care, it’s that we should weed out the wasteful spending. Reigniting the appetite of pork-hungry politicians and their special interests is no way to lower health care costs for the average American, who is faced with unsustainable premium increases and increasing uncertainty. The Biden administration should resist these calls, and instead let the days of the navigator nightmare become a distant memory that simply does not need revisiting.
Hayden Dublois is a Research Analyst at the Foundation for Government Accountability.