UPDATE, December 14, 10:40 a.m.: A PDF for the guide and links to access it appear to have been restored to the CMS website, according to an email from a spokesperson for the Sunlight Foundation’s Web Integrity Project.
The Centers for Medicare & Medicaid Services (CMS) removed from its website a guide to help enroll Latino community members in the Affordable Care Act (ACA) insurance marketplace, according to a report released Thursday by the Sunlight Foundation’s Web Integrity Project. The deletion, made a little over a month before the open enrollment period began on November 1, is just one of many attempts to undermine Latino and immigrant access to public assistance programs and the ACA marketplace.
The removed PDF document consisted of a Powerpoint slideshow detailing specific challenges to enrollment for Latino communities—including limited English proficiency and fear of immigration enforcement—and how to support people in overcoming those barriers. According to the Web Integrity Project report, the guide was removed from the CMS webpage titled “Training for navigators, agents, brokers, and other assisters” in late September. Assisters—who offer support throughout the health insurance enrollment process and include designated navigators, insurance agents, and brokers—are key to expanding access to ACA marketplace plans.
The non-partisan Kaiser Family Foundation released data in January showing the challenges the Latino community faces in accessing adequate health care, including language proficiency and food insecurity.
A CMS spokesperson told the Web Integrity Project that the guide was removed as part of routine “updates and maintenance of CMS.gov” because the PDF “contained outdated information.”
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The Web Integrity Project, however, disputes that assertion:
With the exception of one bullet point that referenced the now-eliminated individual mandate, the information in the PDF remains accurate and relevant to assisters. In fact, another document on the website, the “September Marketplace Update for Assisters” PDF, published in September 2017 with information relevant to assisters, still includes a link to the removed PDF, noting that the best practices “identified in the slide presentation” are examples of how to “model targeted outreach efforts” to other populations.
In late September, as CMS was removing the guide from its website, the Trump administration announced proposed changes to “public charge” rules that would deny legal permanent resident status to immigrants who used government support programs such as SNAP, Section 8 housing, or non-emergency Medicaid. “With the public charge, [it is] clear they’re trying to make it impossible for immigrants to stay here,” Jess Morales Rocketto, political director at the National Domestic Workers Alliance and the chair of the We Belong Together campaign, told Rewire.News when the public charge proposal was announced. “The administration is willing to literally starve them out, and then make it impossible for them to come back or have their families migrate here.”
ACA subsidies are not included under the proposed public charge rule, though advocates remain concerned that immigrants might still forgo enrolling in ACA plans out of fear and confusion about how it might affect a green card application. According to an article in the New England Journal of Medicine from before the proposed rule was released, the public charge rule could cause over 1 million people to stop receiving health coverage they need from Medicaid or the Children’s Health Insurance Program.
Correction: This piece has been updated to clarify the ACA regulations regarding navigator training.