Affordable Care Act Navigator Assistance Grants

Listed by State recipient, direct grantee, and sub-grantee. 


  • Ascension Health – $232,406
    • Providence Health
  • AIDS Alabama – $531,080
    • AIDS Action Coalition (AAC)
    • West Alabama AIDS Outreach (WAAO)
    • Unity Wellness Center (UWC)
    • Montgomery AIDS Outreach, Inc. (MAO)
    • Selma AIDS Information and Referrals (AIR)
    • AIDS Alabama South (AALS)
    • The Right Place
  • AIDS Alabama – $531,080
    • Tombigbee Healthcare Authority
    • Health Resources of West Alabama
    • Tuskegee Area Health Education Center (TAHEC), Inc.
    • Health and Wellness Education Center
    • Sowing Seeds of Hope
    • Monroe County Hospital


  • United Way Anchorage – $300,00
    • Alaska Native Tribal Health Consortium
  • Alaska Native Tribal Health Consortium – $299,918


  • Arizona Association of Community Health Centers – $1,344,096
    • Kids Health Link
    • Nuestra Salud
    • Pima County Access Program (PCAP)
    • Pima County Health Dep’t
    • St. Elizabeth’s of Hungary
    • United Way of Tucson & Southern Arizona
  • Arizona Board of Regents, Univ. of Arizona – $190,268
  • Greater Phoenix Urban League, Inc. – $523,773
    • Arizona Family Health Partnership (AFHP)
    • Empact-La Frontera (ELF)
    • Coconino County Health Department (CCHD)
    • Tucson Urban League (TYL)
    • Women’s Health Coalition of AZ (WHC)
  • Campesinos Sin Fronteras, Inc. – $71,386


  • Southern United Neighborhoods – $270,193
    • Local 100 United Labor Unions
    • Arkansas Community Institute (ACI)
  • Univ. of Arkansas – $774,745
    • Partners for Inclusive Communities – Dep’t at Univ. of Arkansas


  • Chatman, LLC – $510,577
    • Local physicians’ offices
    • Accountable Care Organizations


  • Univ. of South Florida – $4,213,696
    • FL Covering Kids & Families (CKF) (lead applicant, based in Univ. of South FL)
    • Health Council of SE Florida
    • Kids Healthcare Foundation
    • Primary Care Access Network (PCAN)
    • Health Planning Council of Southwest Florida
  • Epilepsy Foundation of Florida – $637,686
    • Univ. of West Florida in Pensacola
    • Univ. of FL in Gainesville
    • Univ. of North Florida in Jacksonville
    • Florida Atlantic University in Boca Raton
    • Nova Southeastern University in Davie
    • Florida Memorial University in Opa-Locka
  • Advanced Patient Advocacy, LLC – $413,152
    • Holy Cross Hospital
    • Bethesda Memorial Hospital
  • Legal Aid Society of Palm Beach County, Inc. – $446,783
    • Healthcare Access Partnership Initiative (HAPI)
    • Legal Aid’s Housing Project
  • Pinellas County Board of County Commissioners – $600,000
    • Pinellas County Health Dep’t
    • Juvenile Welfare Board
    • St. Petersburg College
    • St. Petersburg Free Clinic
    • Clearwater Free Clinic
    • YMCA
  • National Hispanic Council on Aging – $646,825
    • Local community partners; graduates of the Empowerment and Civic Engagement Training program
  • Mental Health America – $686,691
    • Mental Health America of East Central Florida (MHAECF)
  • Public Health Trust of Miami Dade County dba Jackson Health System – $238,000
    • Jackson Memorial Hospital
    • Holtz Children’s Hospital
    • Jackson Rehabilitation Hospital
    • Jackson South Community Hospital
    • Jackson North Medical Center
    • Jackson Mental Health Hospital


  • Structured Employment Economic Development Corporation (SEEDCO) – $2,159,360
    • Boat People SOS
    • Center for Black Women’s Wellness
    • Emory-Grady Urban Health Initiative
    • Georgia Equality & The Health Initiative
    • Georgia Refugee Health and Mental Health
    • Georgia Watch
    • Georgians for a Healthy Future
    • Healthy Mothers Healthy Babies Coalition
    • Jewish Family & Career Services
    • Latin American Association
    • Mental Health America of Georgia
    • Parent to Parent, Quality Med-Care Inc.
    • Spring Creek Health Cooperative
  • Univ. of GA – $1,657,378


  • Southern Illinois Healthcare Foundation – $240,113
    • Southern Illinois Healthcare Foundation (SIHF)
    • Christopher Rural Health Planning (CRHPC)
    • Community Health and Emergency Services (CHES)
    • Rural Health Incorporated (RHI)
    • Shawnee Health Services (SHS)
  • Genesis Health System – $137,283
    • Existing community partners
  • Sinai Health System – $157,271
    • 60 WIC office sites operated by Sinai
    • Chicago Dep’t of Public Health
    • Community and Economic Development Association of Cook County
    • Cook County Dep’t of Public Health
    • Mile Square Health Center
    • Near North Health Service Corporation
    • Stickney Public Health District
    • TCA Health Inc.
    • Regional and local Community Based Organizations
    • Federally qualified healthcare centers such as Lawndale Christian Health Center
    • Faith Based Organizations
  • Dupage County Health Dep’t – $182,543
  • A Safe Haven foundation – $324,736
  • Mercy Hospital and Medical Center – $452,590
  • Puerto Rican Cultural Center, Inc. – $600,000
  • VNA Health Care – $132,737
  • IL College of Optometry – $504,016
  • National Council of Urban Indian Health – $35,000
    • Local Urban Indian Health Program (UIHP) in Chicago
  • SER-Jobs for Progress National, Inc. – $294,182
    • Central States SER


  • Affiliated Service Providers of Indiana, Inc. – $897,150
    • Behavioral Health Network
    • Community Mental Health Centers
    • Ivy Tech Community College
  • Plus One Enterprises, LTD, LLC – $130,875
  • Health and Hospital Corporation of Marion County – $590,895
  • United Way Worldwide – $424,586
    • State-wide partners and 2-1-1 call center


  • Genesis Health System – $128,430
    • Existing community partners
  • Visiting Nurse Services of IA – $257,142
    • HCI Care Services
  • Planned Parenthood of the Heartland – $214,427
    • Ames Center, Ankeny Center, My Health Express, Rosenfield Center, Susan Knapp, and West Center
    • Burlington, Cedar Falls, Cedar Rapids, Council Bluffs Center, Creston Center, Dubuque Center, Fort Dodge Center, Iowa City, Mount Pleasant, Quad Cities Center, Red Oak Center, Sioux City Center, Washington


  • Ascension Health – $165,683
    • Via Christi Health System (VCHS)
  • Advanced Patient Advocacy LLC – $195,556
    • Overland Park Regional Medical Center
    • Labette County Medical Center
    • Menorah Medical Center
  • Kansas Association for the Medically Underserved – $524,846
    • Kansas Hospital Education and Research Foundation
    • Kansas Insurance Department
    • Kansas Association of Local Health Departments
    • Association of Community Mental Health Centers of Kansas
    • Kansas Association of Area Agencies on Aging and Disabilities (operating as volunteer based Senior Health Insurance Assistance Program)


  • Southern United Neighborhoods – $486,123
    • Local 100 United Labor Unions
    • Affiliated Media Foundation Movement (AMFM)
    • Arkansas Community Institute (ACI)
  • Martin Luther King Health Center, Inc. – $81,066
  • Southwest Louisiana Area Health Education Center – $1,099,985
    • Central Louisiana AHEC
    • North Louisiana AHEC
    • Southeast Louisiana AHEC
  • Capital Area Agency on Aging, District II, Inc. – $100,000


  • Western Maine Community Action – $475,000
    • Aroostook County Action Program
    • Kennebec Valley Community Action Program
    • Midcoast Maine Community Action
    • Waldo Community Action Partners
    • Washington Hancock Community Agency
    • The Opportunity Alliance
    • York County Community Action Corporation
  • Fishing Partnership Health Plan – $66,846


  • Community Bridges Management, Inc. – $896,366
    • ZIAD Healthcare for the Underserved
  • Arab Community Center for Economic & Social Services – $276,593
  • American Indian Health & Family Services of SE Michigan, Inc. – $49,583
  • Michigan Consumers for Healthcare – $1,319,345
    • Michigan Community Action Agency Association
    • Michigan Primary Care Association
    • Michigan Association of Community Mental Health Boards
    • Michigan Tribal Health Center Directors Association


  • Oak Hill Missionary Baptist Church Ministries – $317,742
    • Mid-South Churches Cooperative Conference (MSCCC)
    • Collaborative of 200 churches and faith organizations
  • Univ. of Mississippi Medical Center – $831,986
    • Mississippi Institute for Improvement of Geographic Minority Health
    • Univ. of Mississippi Adult Hospital
    • University Physicians and Associates
    • Blair E. Batson Children’s Hospital
    • Wiser Hospital for Women and Infants
    • Conerly Critical Care Hospital
    • Holmes County Hospital
    • E-Beat


  • Primaris Healthcare Business Solutions – $1,045,624
    • APPLE Project
    • Bi-Lingual International Assistant Services
    • Interfaith Community Services
    • Eastern Missouri Health Services
    • Heartland Resources
    • Missouri Kidney Program
    • OASIS Institute
    • Ozark Action, Inc.
    • Senior Adult Services, Inc.
    • Shepherd Center of Kansas City Central
    • Missouri Alliance of Area Agencies on Aging
    • Northwest Missouri Area Agency on Aging
    • Region X Area Agency on Aging
    • Care connection for Aging Services
    • Southeast Missouri Area Agency on Aging
    • Southwest Missouri Office on Aging
    • Central Missouri Area on Aging
    • Mid-East Area Agency on Aging


  • Intermountain Planned Parenthood, Inc. DBA Planned Parenthood – $295,604
    • Navigators placed in five health clinic sites
  • Montana Primary Care Association, Inc. – $299,382
    • Community health centers around the state
    • Rural Health Development DBA Montana Health Network
    • Big Horn Hospital Association
    • Beartooth Billings Clinic
    • Central Montana Medical Center
    • Dahl Memorial Healthcare Assoc.
    • Daniels Memorial Healthcare Center
    • Fallon Medical Complex
    • Frances Mahon Deaconess Hospital
    • Garfield County Health Center
    • Glendive Medical Center
    • Holy Rosary Healthcare
    • Livingston Health Care
    • McCone County Health Center
    • Northeast MT Health Services
    • Phillips County Hospital
    • Prairie County Hospital
    • Roosevelt Medical Center
    • Roundup Memorial Hospital
    • Sheridan Memorial Hospital Assoc.
    • Sidney Health Center
    • Stillwater Billings Clinic
    • Wheatland Memorial Healthcare


  • Community Action of Nebraska, Inc. – $562,457
    • 9 community action agencies
  • Ponca Tribe of Nebraska – $37,543

New Hampshire

  • Bi-State Primary Care Association – $454,839
    • North Country Health Consortium
    • Ammonoosuc Community Health Services, Inc.
    • Coos County Family Health Services, Inc.
    • Families First Health and Support Center
    • Goodwin Community Health
    • Harbor Care Clinic, A Program of Harbor Homes, Inc.
    • Health First Family Care Center
    • Indian Stream Health Center
    • Lamprey Health Care
    • Manchester Community Health Center
    • Mid-State Health Center
    • Weeks Medical Center
    • White Mountain Community Health Center
  • Planned Parenthood of Northern New England -$145,161
    • Navigators in 6 health clinics

New Jersey

  • Center for Family Services, Inc. – $677,797
    • Wendy Sykes – The Oranges ACA Navigator Project
    • African Americans for Health Awareness
    • Essex County Family Support Organization
    • East Orange/Orange CDC
    • Newark Beth Israel – Geriatrics
    • Healthy Family Adventures
  • Urban League of Hudson  County – $565,000
    • Urban League of Bergen County
    • Urban League of Morris County
    • Urban League of Union County
  • Public Health Solutions – $400,583
    • Newark Emergency Services for Families
    • Partnership for Maternal and Child Health of Northern New Jersey
    • Dep’t of HHS – City of Jersey City

North Carolina

  • Randolph Hospital, Inc. – $352,320
  • Mountain Projects, Inc. – $359,750
  • NC Community Care Networks – $1,988,428
  • Alcohol/Drug Council of NC – $324,798

North Carolina

  • Great Plains Tribal Chairmen’s Health Board – $186,000
    • Tribal Health Departments
    • Tribal Maternal
    • Child Health Programs
    • Aberdeen Area Indian Health Service Area
    • North Dakota State Dep’t of Health
  • Minot State University – ND Center for Persons with Disabilities – $414,000
    • Family Voices
    • Federation for Families
    • First Link
    • Community HealthCare Association of the Dakotas
    • Northland Healthcare Network


  • Ohio Association of Foodbanks – $2,014,750
    • OH Association of Foodbanks
    • Access Health Mahoning Valley
    • Asian Services in Action, Inc.
    • Carmella Rose Health Foundation
    • Cuyahoga Health Access Partnership
    • Community Action Committee of Pike County
    • Disability Rights Ohio
    • Health Care Access Now
    • Heart of OH Family Health Center
    • Hospital Council of NW OH
    • OH Association of Free Clinics
    • OH Dep’t of Health
    • United Way of Greater Cleveland 2-1-1
    • Community Action Program Corporation of Washington Morgan Counties
    • Western Reserve Area Agency on Aging
  • Helping Hands Community Outreach Center – $230,920
    • Local Community Action Partnership
    • Several churches
    • Grassroots community based providers
    • Spirit of Peace CDC
    • Neighborhood Health Association
    • Three NHA FQHC clinics


  • OK Community Health Centers, Inc. – $860,866
    • OK Primary Care Association
    • 18 health center grantees
    • OK 2-1-1 agencies
    • Legal Aid Services of OK
    • Planned Parenthood of the Heartland – Eastern OK
    • Planned Parenthood of Central OK
  • Little Dixie Community action Agency, Inc. – $580,733
    • Little Dixie Community Action Agency
    • Big Five Community Services
    • Community Development Corporation
    • Community Development Support Association
    • Delta Community Action Foundation
    • Deep Fork Community Action Foundation
    • Great Plains Improvement Foundation
    • INCA Community Services
    • KIBOIS Community Action Foundation
    • Muskogee County Community Action Foundation
    • Northeast OK Community Action Agency
    • Opportunities Inc.
    • SW OK Community Action Group
    • Washita Valley Community Action Council
  • Latino Community Development Agency – $178,500


  • Resources for Human Development – $997,801
  • Pennsylvania Association of Community Health Centers – $739,005
    • Health Federation of Philadelphia
    • Pennsylvania Health Law Project
    • Pennsylvania Office of Rural Health
  • Pennsylvania Mental Health Consumers’ Association – $424,625
    • PA Mental Health Consumers Association
    • Mental Health Association in PA
    • Mental Health Center Westmoreland County
  • Mental Health America – $547,754
    • Mental Health Association of SE PA

South Carolina

  • DECO Recovery Management LLC – $1,211,203
    • Benefit Bank of South Carolina
    • South Carolina Office of Rural Health
    • SC Chamber of Commerce
    • SC Hospital Association
  • Cooperative Ministry – $508,313
    • Greater Columbia Community Relations Council
    • SC Progressive Network
  • Beaufort County Black Chamber of Commerce – $234,099

South Dakota

  • SD Community Action Partnership – $336,000
    • Inter-Lakes Community Action Partnership
    • Rural Office of Community Services, Inc.
    • NESDCAP dba GROW South Dakota
    • Western South Dakota Community Action
  • Great Plains Tribal Chairmen’s Health Board – $264,000
    • Tribal Health Departments
    • Aberdeen Area Indian Health Service Area
    • South Dakota State Dep’t of Health


  • Structured Employment Economic Development Corporation (SEEDCO) – $1,216,013
    • Appalachian Mountain Project Access
    • Bridges
    • Community Development council
    • Family and Children’s Services
    • Knoxville Area Project Access
    • Medical Foundation of Chattanooga
    • Porter-Leath
    • TN Community Services Agency
    • Tennessee Health Care campaign
  • Tennessee Primary Care Association – $781,265
    • East Jackson Family Health
    • Faith Family Medical
    • GetWell Community Clinic


  • United Way of Metropolitan Tarrant County – $5,889,181
    • Alamo Area Council of Governments
    • Brazos Valley Council of Governments
    • City of Houston Dep’t of HHS
    • Community Council of Greater Dallas
    • LIFE Inc. / Disability Connections for Independent Living
    • Panhandle Regional Planning Commission
    • Project Amistad
    • South TX Development Council
    • Starcare Specialty Health System
    • United Way of Central Texas
  • Migrant Health Promotion, Inc. – $589,750
    • Rio Grande Valley of Texas
  • National Hispanic Council on Aging – $646,825
  • Change Happens – $785,000
    • The Children’s Center
    • Children’s Books on Wheels
    • Houston Center for Independent Living
    • Faith-Based Recovery Health and Wellness Network
  • United Way of El Paso County – $642,121
    • AVANCE
    • City of El Paso
    • County of El Paso
    • Greater El Paso Chamber of Commerce
    • El Paso Hispanic Chamber of Commerce
    • El Paso Interreligious Sponsoring Organization
    • Educational Service Center
  • Southern United Neighborhoods – $600,678
    • Local 100 United Labor Unions
    • Affiliated Media Foundation Movement
    • Arkansas Community Institute
  • East Texas Behavioral Healthcare Network – $1,337,520
    • Anderson / Cherokee County Enrichment Services
    • Andrews Center
    • Betty Hardwick Center
    • Bluebonnet Trails Community MHMR Center
    • Burke Center
    • Community Healthcore
    • Gulf Bend MHMR Center
    • Gulf Coast Center
    • Lakes Regional MHMR
    • Pecan Valley MHMR Region
    • Spindletop Center
    • Tri-County MHMR Services
  • National Urban League – $376,800
    • Urban League of Greater Dallas & North Central Texas
    • Houston Area Urban League


  • Utah Health Policy Project – $486,121
    • Association for Utah Community Health
    • United Way
    • Take Care Utah
  • Utah AIDS Foundation – $205,591
    • Utah Pride Center
    • Ogden OUTreach
    • Planned Parenthood
    • National Council of Urban Indian Health


  • Virginia Poverty Law Center, Inc. – $1,278,592
    • Young Invincibles project of the Center for Community Change
    • Blue Ridge Legal Services
    • Central Virginia Legal Aid Society
    • Legal Aid Justice Center
    • Legal Aid Society of Eastern Virginia
    • Legal Aid  Society of Roanoke Valley
    • Legal Services of Northern Virginia
    • Southwest Virginia Legal Aid Society
    • Virginia Legal Aid Society
  • Advanced Patient Advocacy LLC – $483,433
    • Chippenham Hospital
    • Johnston-Willis Hospital
    • John Randolph Henrico Doctors Hospital
    • Retreat, St. Mary’s Hospital
    • Memorial Medical center
    • St. Francis
    • Richmond Community Hospital
    • Sentara Northern Virginia Medical Center
    • Fauquier Hospital and Reston Hospital
    • Mary Washington Hospital
    • Stafford Hospital
    • Spotsylvania Regional Medical & Rappahannock General Hospital
    • Lewis Gale Montgomery Regional Hospital
    • Clinch Valley Medical Center
    • Lewis-Gale Alleghany
    • Lewis-Gale Pulaski
    • Lewis-Gale Medical Center

West Virginia

  • Advanced Patient Advocacy LLC – $276,617
    • Raleigh General Hospital
    • HCA St. Francis and Pleasant Valley Hospital
    • Thomas Memorial Hospital
    • Princeton Community Hospital
    • Pavilion
  • National Healthy Start Association – $191,667
  • TSG Consulting LLC – $174,091
    • WV Farm Bureau
    • Partners in Health Network


  • Partners for Community Development, Inc. – $315,720
  • NW Wisconsin Concentrated Employment Program, Inc. – $285,035
    • Western Wisconsin Workforce Investment Board, Inc.
    • Western Wisconsin Workforce Development Board, Inc.
    • North Central Workforce Development Board, Inc.
    • Workforce Resources, Inc.
    • Workforce Connections, Inc.
  • Legal Action of Wisconsin Inc. / SeniorLAW – $70,000
  • National Council of Urban Indian Health – $35,000
  • National Healthy Start Association – $191,667
  • R&B Receivables Management Corporation DBA R&B Solutions – $104,520


  • Memorial Hospital of Laramie County DBA Cheyenne Regional – $401,281
    • Wyoming 2-1-1
    • 9 Faith Community Nurse Locations
    • 18 Facilities
    • 11 Hospitals
  • Wyoming Senior Citizens, Inc. – $198,719

Washington Examiner: Complaint suggests HUD may have inappropriately promoted Obamacare

Read the full story: Washington Examiner

Cause of Action also alleges that HUD may have violated prohibitions against using appropriated funds “for publicity or propaganda purposes not authorized by the Congress,” as listed in the third edition of “Principles of Federal Appropriations Law,” volume one. None of the suggested Obamacare promotion is specifically mentioned in HUD’s appropriations.


In its letter to HHS Inspector General Daniel Levinson, Cause of Action alleged the agency may have “improperly augmented its appropriation by inducing or accepting HUD’s improper use of appropriations.”


“[I]f HHS was an active participant in the creation of materials or strategies the White House distributed to other agencies, including HUD, then HHS was complicit in the appropriation violations committed by those other agencies,” Cause of Action said.

Government Executive: Transparency Group Wants to Know If HUD’s Promotion of Obamacare Was Illegal

Read the full story: Government Executive

Cause of Action suggested that numerous high-level HUD officials and regional administrators may have “improperly directed subordinate staff to engage in activity that violated HUD’s appropriations.”


A second letter to HHS watchdog Daniel Levinson added an assertion that HHS, by accepting volunteer services from other agencies, may have violated the Anti-Deficiency Act.


Copies were sent to dozens of lawmakers with oversight and appropriations duties.

James Valvo on the Lars Larson Show 4/14/2014

Cause of Action’s James Valvo talks with Lars Larson about our letters to HUD and HHS Inspectors General asking them to investigate whether HHS violated any laws when HUD coordinated with HHS and the White House in implementing the Patient Protection and Affordable Care Act (PPACA).

Related Stories:

Start the clip at 1.24.10:

CoA Letters Requesting Investigations of HUD and HHS in Implementation of Health Care Law

Cause of Action sent letters to the Inspectors General of the Department of Health and Human Services (HHS) the Department of Housing and Urban Development (HUD) asking them to investigate whether HHS violated any laws when HUD coordinated with HHS and the White House in implementing the Patient Protection and Affordable Care Act (PPACA).

Letter to HHS Inspector General

Letter to HUD Inspector General

Read the embedded letters below:

HUD IG Letter by CauseOfAction

HHS IG Letter by CauseOfAction

Fox News: Enroll America under fire again after video suggests involvement in partisan politics

Read the full story: Fox News

“Despite its claims of serving the public good, it appears that Enroll America has abused its tax-exempt status by using donor contributions for political and other impermissible purposes,” the group said Friday.


Cause of Action also argues Tarango’s comments indicate Enroll is “engaging in political activity by coordinating with the pro-President Obama group Organizing for Action, a 501(c)(4) organization.

Forbes: Dan Epstein: Obamacare’s Implementation Poses Grave, But Largely Unknown Risks For Beneficiaries

Obamacare’s Implementation Poses Grave, But Largely Unknown Risks For Beneficiaries

By Dan Epstein        September 30, 2013

Many of us are concerned and anxious because we don’t know what the Patient Protection and Affordable Care Act (ACA), also known as Obamacare, will mean for our personal health care, our families and our pocketbooks as enrollment commences October 1.  The American people are likely unaware of the risks they face in disclosing their personal medical and financial information to strangers through the enrollment programs and have not been well informed of the potential for state entities to violate federal laws during the implementation of the ACA.

In an aggressive effort to recruit Americans into the ACA, the federal government has implemented “Navigator” and “Assister” programs.  These programs lack not just training and oversight, but also background checks, fingerprinting or other screening that should be required prior to obtaining Americans’ social security numbers, addresses, and personal medical information.  Recognizing these security concerns, thirteen Attorneys General wrote to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius on August 14, 2013 warning that “…this is a privacy disaster waiting to happen.”  On September 18, 2013, the House Oversight and Government Reform Committee issued a troubling report detailing how navigators and assisters not only threaten to harm consumer privacy and misuse consumer data but are also being carried out by individuals who have not been subject to background checks or other certifications.  Concerned about the potential liabilities associated with these navigator and assister programs, entities in Ohio, Florida, Oklahoma, Pennsylvania, Utah and West Virginia have already voluntarily returned federal navigator grant money.

But another area of concern that has not yet received much attention is the risk of waste, fraud and abuse of the hundreds of millions of taxpayer dollars states are receiving to run their exchanges or marketplaces.  For example, California has received $910 million; New York, $369 million; and Hawaii, $205 million.  And this is just the beginning.  Additional funds will likely be pumped into the system if the navigators and assisters are unable to meet their enrollment “quotas.”   Entities within states should be on high alert regarding their risk of violating laws as implementation of the ACA occurs.  For example, using any false writings or documents known to be materially fictitious, concealing a material fact, or making any fraudulent or fictitious statements to a government representative about the use of grant funds are violations of 18 U.S.C. § 1001.  Further, under OMB Circular A-87, state and local entities that receive federal funding are required to adequately document all costs associated with administering the grant funds. If a recipient falsely certifies that they are conforming to this regulation, or if they do not properly document federal grant funds that are being primarily utilized for state programs, they may be subject to liability under both the OMB Circular A-87 and the False Claims Act. An Inspector General found that the IRS largely failed to account for and report these costs associated with implementing ACA. If our federal agencies are failing at this oversight, it follows that states cannot be adequately equipped, aware, or prepared to conduct oversight over implementation of the ACA, setting these state exchanges up for failure.

Cause of Action (CoA) is concerned about the potential for waste, fraud and abuse of these funds given to state entities.  This is why we have sent liability alert letters to more than 35 Governors thus far, and the District of Columbia, alerting them to the risks involved with the unintended misuse and waste of the ACA grant funds.  Given the hundreds of millions of federal taxpayer dollars at stake, taxpayers should hold their elected representatives accountable for how their money is being spent.

The grim reality is that the Affordable Care Act is deceptively complex and non-transparent.  Americans need to be cautious about enrolling in Obamacare (i.e., providing personal, medical and financial information to unchecked strangers), and mindful of the potential for misuse of taxpayer funds given the myriad, untested liability pitfalls and the vast sums of taxpayer money at stake.  At a minimum, the American people deserve to have our elected representatives and federal government provide proper oversight of the implementation of the Affordable Care Act.


Dan Epstein is the executive director of Cause of Action, a non-profit, nonpartisan government accountability organization.