Federal cuts slash more than $2M from Foundation Communities' health navigator program

Federal cuts slash more than $2M from Foundation Communities' health navigator program

Wednesday, February 19, 2025 by Chad Swiatecki

The Foundation Communities nonprofit is facing a substantial financial setback after the Trump administration announced a 90 percent reduction in funding for health insurance navigator grants. The cuts, revealed last Friday, eliminate nearly all funding for 56 programs nationwide that help Americans enroll in affordable health insurance through the Affordable Care Act Marketplace.

Foundation Communities' Prosper Health Coverage program, which was expecting to receive $2.4 million for the next enrollment period, is among those affected.

The nonprofit has provided ACA enrollment assistance since the marketplace first launched in 2013. Executive Director Walter Moreau said the program initially relied heavily on volunteers and consistently facilitated around 5,000 enrollments annually, with more than 6,800 enrolled in the 2023-24 period.

The organization significantly expanded its impact five years ago after securing a federal navigator grant, which allowed for a professional, year-round staff of specialists dedicated to health insurance enrollment and education.

"The navigator grant by and large pays for full-time, year-round staff who are really specialists and experts in health insurance enrollment – both Marketplace, Medicaid, CHIP and how to use your insurance," Moreau said, noting the grant had recently doubled to allow the group to provide more help for at-risk communities including rural residents, low-income families, the LGBTQ community and individuals with limited English proficiency.

The added funding also allowed enrollees to receive more help to make sure they were getting the maximum services available and not overpaying for coverage.

"We do a lot of what we call 'coverage to care,'" said Erika Leos, director of the Prosper Health Coverage program. "After open enrollment is over, we reach out to everyone we helped enroll and ask: Have you been able to use your health insurance? Do you need help connecting with a provider? Have you had any bills you weren't expecting? Have you had any trouble accessing care?"

With the federal navigator grant set to expire in late August, Foundation Communities is preparing for a possible funding shortfall, including the expected reimbursements for costs associated with the recently concluded marketplace enrollment period. While the navigation program will continue, Moreau said Foundation Communities will need to rely more on volunteers and seek increased support from local health institutions, hospitals and community partners.

"We are absolutely committed to keeping the program going," Moreau said. "We may not enroll quite as many people or be able to provide the same level of services, but we think we can still have a really robust program."

Historically, the nonprofit has received funding from St. David's Foundation, the city of Austin and Central Health. While city funding has lapsed in recent years, Moreau said discussions are already underway with local stakeholders, including Central Health, which is expected to address the issue in an upcoming board meeting.

"The response from our health partners has been very positive," he said. "The health care industry benefits when more people have coverage, so it makes economic sense for them to support this effort."

Leos criticized the new administration's justification for the cuts, which focused on efficiency and cost per enrollment.

"It was just really interesting to see the language in the press release talking about efficiency – how many enrollments per dollar – when for the last several years, we've been expanding beyond just enrollments," she said. "We've been expanding in making sure people have the education, the knowledge and the support they need to fully benefit from their insurance."

Moreau added that the organization has run one of the most cost-effective programs in the country.

"Our program enrolled 6,853 Central Texans in health coverage in the 2023-2024 season. With a cost of just $268 per enrollee, we ranked fourth out of 56 programs," he said.

Photo made available through a Creative Commons license.

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