Navigator groups that help educate and enroll consumers in the Affordable Care Act insurance exchanges are shutting down because the federal government isn’t paying them.

Several navigator organizations, including the University of South Florida, which received the country’s largest federal grant for navigation services in 2016, are suspending education and outreach activities ahead of the 2018 open enrollment period that is slated to begin Nov. 1.

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Half of Virginia’s counties now are on track to have no health insurers offering Obamacare plans in 2018 after an insurer reversed a decision to sell individual health coverage in much of the state.

The pullback by Optima Health in Virginia ends a brief, two-week period in which every county in the United States was projected to have at least one Obamacare insurer next year.

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Lawmakers and policy experts are honing in on a small handful of policies — mostly, different forms of federal funding and regulatory flexibility — as the Senate tries its hand at a bipartisan Affordable Care Act fix.

The first of several Senate HELP Committee hearings on the individual market included topics such as funding the cost-sharing subsidies, and expanding regulatory waivers for states. A handful of other policy ideas, including direct government payments to help offset the costs of expensive patients, were also discussed.

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California and several other states will exempt themselves this year from a new Trump administration rule that cuts in half the amount of time consumers have to buy individual health insurance under the Affordable Care Act.

In California, lawmakers are contemplating legislation that would circumvent the rule in future years, too.

The Trump administration’s rule gives people shopping for 2018 coverage on the federal exchange 45 days to sign up, from Nov. 1 through Dec. 15.

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Major healthcare insurer Anthem will only offer Obamacare exchange plans in roughly half of Kentucky’s 120 counties due to mounting policy uncertainty from Washington and a deteriorating market.

Anthem had earlier planned to offer individual market plans in every county in Kentucky. However, the insurer said that lingering problems with the market and massive federal uncertainty has forced its hand.

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Virginia became the latest state at risk of having regions that will lack Affordable Care Act exchange plans next year, after a small insurer announced it will scale back the area where it expects to offer marketplace insurance.

The Virginia area that currently has no 2018 exchange insurer includes 48 counties and parts of six more, as well as 15 cities that are independent of counties, according to a Virginia state regulator. In total, the state has 95 counties and 38 independent cities.

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HHS plans to save taxpayer dollars by curtailing waste and requiring better performance in the ACA Navigator program which pays organizations to enroll people in ObamaCare coverage. The HHS analysis showed that in 2016 “One [Navigator] grantee received $200,000 and enrolled ONE person in Obamacare.” The top 10 most costly Navigators spent a total of $2.77 million to enroll 314 people in Obamacare—costing an average of $8,800 to enroll each person (on top of tax credits and other subsidies). In the upcoming enrollment period, CMS plans to spend $10 million on promotional activities—consistent with similar spending on Medicare Advantage and Medicare Part D.

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The Department of Health and Human Services announced today it’s slashing the advertising and promotional budget for the Affordable Care Act for next year. It’s planning to spend $10 million to promote the law in the open enrollment period that starts in November — compared to the $100 million the Obama administration spent last year.

On a conference call with reporters, HHS officials argued that last year’s promotional spending — which was doubled from the year before — was ineffective because signups for new customers actually went down.

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A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules.

In a blueprint issued Thursday, the eight governors ask House and Senate leaders of both parties to take several steps to reverse the rising rates and dwindling choices facing many of the 10 million Americans who buy health plans on their own through ACA marketplaces.

Specifically, the state leaders say Congress should devote money for at least two years toward “cost-sharing subsidies” that the 2010 health-care law promises to pay ACA insurers to offset deductibles and other out-of-pocket expenses for lower-income customers.

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A group of 11 states and the District of Columbia running their own Obamacare exchanges want more federal funding to stabilize exchanges facing higher premiums and insurer defections.

The states wrote to leaders of the Senate Health, Education, Labor and Pensions Committee with their ideas on Tuesday. Those include guaranteeing insurer payments and establishing a permanent reinsurance fund to help insurers.

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