Press Releases

Link to letter here.

WASHINGTON, D.C. – Today, Congresswoman Lisa Blunt Rochester (DE-AL) led all Energy and Commerce Committee Democrats in sending a letter to U.S. Secretary of Health and Human Services (HHS) Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma. The letter calls for HHS and CMS to make public any and all documents, including results of studies, briefing presentations, and data sets, including econometric models and individual-level experiments, regarding the effectiveness of marketing and outreach efforts for the Affordable Care Act.

“If we are to stabilize the Affordable Care Act, we need to take a 360-degree approach that revisits the cost of prescription drugs, how we incentivize new states to establish state-based markets, and how we attract younger, healthy people to sign up and get covered,” said Congresswoman Blunt Rochester. “We have long known the value that marketing and outreach play in attracting new enrollees to the risk pool, but we have not had the CMS data to back it up. That’s why it is alarming that new documents and testimony have come to light that reveals that CMS is suppressing an internal, multi-year study highlighting the success and cost-effective results from ACA marketing. This deceptive act is another in a long line from the Administration to slowly undermine strength and trust in our health care system, and we cannot let that stand. We are pressing for the truth so that we can have the best available data possible in our efforts to stabilize the health care marketplace and lower the cost of care for the people.”

"While State-Based Exchanges continue to set enrollment records, every year the Trump Administration oversees HealthCare.gov the number of new people signing up for coverage plummets. The difference is not some great mystery. The studies conducted by CMS are definitive, marketing is vital for enrollment, and we know the administration knew that when they cut the budget by 90%," said Joshua Peck, co-founder of Get Covered America.

In February, Congresswoman Blunt Rochester introduced H.R. 987, the “Marketing and Outreach Restoration to Empower Health Education Act of 2019” or the “MORE Health Education Act.” This bill would restore outreach and enrollment funding to assist consumers in signing up for health care, which has been slashed by the Trump Administration by 90% since entering office. Fact sheet for H.R. 987 can be found here.

List of co-signers include:

•           Chairman Frank Pallone, Jr.

•           Health Subcommittee Chairwoman Anna G. Eshoo

•           Rep. Bobby Rush

•           Rep. Eliot Engel

•           Rep. Diana DeGette

•           Rep. Michael Doyle

•           Rep. Jan Schakowsky

•           Rep. G.K. Butterfield

•           Rep. Doris Matsui

•           Rep. Kathy Castor

•           Rep. John Sarbanes

•           Rep. Jerry McNerney

•           Rep. Peter Welch

•           Rep. Ben Ray Lujan

•           Rep. Paul Tonko

•           Rep. Yvette Clarke

•           Rep. Dave Loebsack

•           Rep. Kurt Schrader

•           Rep. Joseph Kennedy

•           Rep. Tony Cardenas

•           Rep. Raul Ruiz

•           Rep. Scott Peters

•           Rep. Debbie Dingell

•           Rep. Marc Veasey

•           Rep. Ann McLane Kuster

•           Rep. Robin Kelly

•           Rep. Nanette Barragan

•           Rep. Donald McEachin

•           Rep. Darren Soto

•           Rep. Tom O’Halleran

Text of the letter below:

March 27, 2019

 

The Honorable Alex Azar

Secretary

U.S. Department of Health and Human Services

200 Independence Avenue, S.W.

Washington, D.C. 20201

 

The Honorable Seema Verma

Administrator

Centers for Medicare and Medicaid Services

7500 Security Boulevard

Baltimore, MD 21244

 

Dear Secretary Azar and Administrator Verma,

We are writing to request that the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) make public any and all documents, including results of studies, briefing presentations, and underlying data sets in an anonymized way, including econometric models and individual-level experiments, regarding the effectiveness of marketing and outreach efforts for the Affordable Care Act.

Since the close of the 2016 open enrollment period, there has been a steady but dramatic decline particularly in the number of new enrollees. According to the Kaiser Family Foundation, from 2016 to 2019, marketplace enrollment dropped by over 4,250,000 people. While this trend corresponds with a number of alarming policy decisions, including efforts to disincentivize healthy people from enrolling in the exchanges, the shortening of the open enrollment period from 90 to 45 days, and the expansion of short-term and association health plans that provide skimpy and junk coverage, we are deeply concerned about the cuts made to CMS’s marketing and outreach efforts, which have resulted in a 90% funding cut over that time. According to another Kaiser Family Foundation report, in 2018, just 1 in 4 uninsured people or people who buy their own insurance knew that December 15th was the deadline to enroll. Additionally, a Commonwealth Fund report found that 40% of uninsured adults were still unaware of the marketplaces in 2017.

In testimony submitted to the House Committee on Appropriations in February, Joshua Peck, a former Senior Advisor at CMS, cited a never-made-public, multi-year study that outlined CMS’s success through econometric modeling that helped boost enrollment numbers through a cost-effective and multi-medium approach, including email, television, digital, and mail marketing.

Despite the positive results of CMS’s multi-year study, Trump Administration ended all paid marketing efforts – citing cost-saving measures. In Peck’s testimony, he referred to a Freedom of Information Act (FOIA) request from Democracy Forward, which showed that CMS Administrator Seema Verma’s then-Chief of Staff, Brian Colas, received the results of the multi-year study, referenced in Peck’s testimony, three weeks prior to slashing the marketing and outreach budget from $100 million to $10 million. When the decision was made, a CMS fact sheet stated that “no correlation has been seen between Obamacare advertising and either new enrollment or effectuated enrollment.”

According to emails obtained between CMS and Weber Shandwick, the public relations firm handling HealthCare.gov advertising, this cut to critical funding resulted in over 100,000 fewer people enrolling in coverage – a conservative estimate according to Weber Shandwick. In his testimony submitted to the House Committee on Appropriations, Peck estimated that a minimum of 2.3 million new enrollments have been lost due to the Administration’s actions.

To provide greater transparency and visibility to the general public, please provide any and all documents including studies, presentations, fact sheets, underlying data sets anonymized way, or educational materials created from 2014 onward related to marketing and outreach efforts for the Affordable Care Act.

Sincerely,

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