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Trump cuts Obamacare ads by 90 percent The Trump administration is slashing funding for Obamacare outreach ads by 90 percent and cutting grants to groups that sign up people for Obamacare by nearly 40 percent for upcoming 2018 open enrollment.The administration says the reason for the cuts, compared to 2017's open enrollment, is to be more efficient and provide money to activities more likely to get a return on investment in terms of sign-ups. The 2018 open enrollment starts on Nov. 1, and the administration has taken heat from activists and Democrats that it isn't going to do enough to provide outreach. For the 2017 open enrollment, which ended Jan. 31, the Obama administration spent $100 million on ads. That was double the $50 million that was spent on ads for the 2016 open enrollment. In comparison, President Trump's inaugural Obamacare open enrollment will spend $10 million on ads. HHS looked to last year’s open enrollment hefty ad buy of $100 million to justify the cuts. An HHS official also said the public is more aware of Obamacare since 2018 will be the fifth open enrollment. However, the official conceded the Trump administration did not do any new studies on public awareness of the program. The types of ads that will be done are also different, with the administration shying away from television ads and more towards e-mail and digital ads.

Navigator grants get cut, and an overhaul The Trump administration plans to cut by nearly 40 percent grant funding to navigators, which are nonprofits and organizations tasked with signing up people for Obamacare. Navigators will get $37.8 million in grants for 2018, compared to $62.5 million for the 2017 open enrollment push. An HHS official told reporters on Thursday that the program has been inefficient, with 17 navigators who enrolled less than 100 people each, an average cost of $5,000 per enrollee. So HHS is installing a new performance formula that will provide funding based on how well a navigator signed up people. "We believe we are adequately funding and rewarding those that have been successful," another administration official said. The number of navigators is not declining, as HHS  officials have said that all of the 98 navigators will still get some type of funding. The amount will vary based on signup success though.

So where will the money go? It remains to be seen specifically where the funding that was cut will go. Obamacare’s operations are funded in part by user fees paid by Obamacare insurers. However, an HHS official said that Obamacare funding in prior years has gone beyond what it got from the user fees. HHS did not return a follow-up question on how much extra Obamacare funding beyond what it got from the user fees. An HHS official said that it is looking into spending more money into clamping down on fraudulent Obamacare signups. The agency is also exploring providing funding for possible third-party websites that states can use for people to sign up for Obamacare and not have to go through healthcare.gov. Currently residents in 39 states and the District of Columbia use healthcare.gov to pick an Obamacare plan.

Dems shout sabotage! Democrats quickly pounced on the announcement by repeating the attack that the Trump administration is deliberately sabotaging Obamacare’s markets. "The Trump administration is deliberately attempting to sabotage our health care system. When the number of people with health insurance declines and costs skyrocket, the American people will know who's to blame," said Senate Minority Leader Chuck Schumer in a statement. "Republicans should be shoring up markets, not denying consumers their right to full information about health plans and yanking away tens of millions of dollars of expected funding from Navigators, just two months before open enrollment begins," said House Minority Leader Nancy Pelosi. Meanwhile, Sen. Chris Murphy, D-Conn., was more succinct in this tweet.

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email dailyonhealthcare@washingtonexaminer.com for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

Will cutting ad and outreach budget affect risk pools? Doubling budget didn’t seem to help in 2017: Cutting back on ad and navigator could lead to fewer people to be enrolled in Obamacare, and those people would likely be healthy, tweeted Larry Levitt, senior vice president for the nonpartisan Kaiser Family Foundation. “Cutting ACA outreach will result in fewer people insured, and those who fail to sign up will be the healthiest. That will push premiums up,” he tweeted. Levitt also took on the administration’s assertion that it didn’t need to advertise as much since this will be Obamacare’s fifth year of open enrollment. “For [Affordable Care Act] outreach to be successful, it has to be ongoing,” he tweeted. “Apple doesn’t advertise a new iPhone once and then just stop.” Obamacare has had major problems with getting a stable risk pool, which requires getting younger and healthier people to sign up to balance out sicker people that are more expensive. Liberals have argued that because sicker individuals are likely to seek out coverage no matter what, advertising is needed most to attract young and healthy individuals whose participation is essential to establishing a more stable risk pool. However, it should be noted that Obamacare’s ad budget doubled for 2017 and it had no discernable impact on the percentage of younger and healthier individuals signing up.

New Jersey aims to ban drug maker payments to doctors New Jersey Gov. Chris Christie proposed new rules Thursday to ban doctors and prescribers from accepting large payments from drug makers, according to NJ.com. Christie cited the opioid crisis for the new rules, noting that drug and device makers can provide physicians with “lavish” meals and money for speaking at events or consulting. The rules come after NJ Advance Media reported that the state’s top prescribers of fentanyl, a very powerful opioid more potent than heroin, also got payments from the manufacturers of the drug,  according to NJ.com.

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Calendar

FRIDAY, SEPT. 1

8:15 a.m. Bethesda, Md., National Institutes of Health holds a meeting of the Council of Councils. Details.

WEDNESDAY, SEPT. 6

10 a.m. 430 Dirksen. The Senate Health, Education, Labor and Pensions Committee will hold a hearing on stabilizing the Obamacare exchanges. State insurance commissioners will testify. help.senate.gov/hearings/stabilizing-premiums-and-helping-individuals-in-the-individual-insurance-market-for-2018-state-insurance-commissioners

10 a.m., SD-342 Dirksen. The Senate Homeland Security and Governmental Affairs Committee will hold a hearing on the history and current reality of the U.S. healthcare system. https://www.hsgac.senate.gov/hearings/the-history-and-current-reality-of-the-us-health-care-system

THURSDAY, SEPT. 7

9 a.m. 430 Dirksen. The Senate Health, Education, Labor and Pensions Committee will hold a second hearing on stabilizing the Obamacare exchanges, with several governors testifying. help.senate.gov/hearings/stabilizing-premiums-and-helping-individuals-in-the-individual-insurance-market-for-2018-governors

10 a.m., 215 Dirksen.  The Senate Finance Committee holds a hearing on reauthorizing the Children’s Health Insurance Program. https://www.finance.senate.gov/hearings/the-childrens-health-insurance-program-the-path-forward