A program meant to help underserved populations enroll in and navigate the federal health insurance marketplace has slashed millions in funds for grassroots Texas groups, according to the agency that manages the program.

The Centers for Medicare and Medicaid Services, a federal agency that gives grants to “navigators,” said in July that it would only be giving out $10 million, down from from $36 million the year before, the Washington Post reported. The agency said the number of people enrolling in health insurance did not justify the amount spent on the program, which targets hard-to-reach populations for the Affordable Care Act.

For Texas, that means just two community organizations statewide received a total of $1.3 million for the navigator program, documents released Wednesday show. That’s compared to nine groups receiving $6.1 million in 2017 — already a $3 million drop from 2016, reports from those years show.

The two groups to receive funds were Change Happens, a clinic based in Houston, which got $406,297, and MHP Salud, a community health group working in the Rio Grande Valley, Laredo and El Paso, which got $950,000. Neither group immediately responded to calls and emails requesting comment.

Advocates told The Texas Tribune that in the state with the nation’s highest percentage of uninsured people, this cut in funding may harm health care for vulnerable groups in Texas — who receive targeted outreach and assistance in dealing with the Affordable Care Act from groups funded by the initiative.

“There’s a lot of complexity … that would keep an average consumer from being able to navigate the system by themselves,” said Stacey Pogue, a senior policy analyst at the left-leaning Center for Public Policy Priorities. “Now, this is just one more barrier.”

Furjen Deng of the Light and Salt Association, a Chinese community group in Houston, said she was stunned when she learned her group did not receive funding.

Through the navigator program, her group had hired 25 full-time employees to enroll members of Houston’s Chinese community in health insurance, either through the marketplace or Medicaid.

Light and Salt also distributed its grant funds among a dozen Asian-American groups across Texas. Deng said that a grant of nearly $450,000 helped enroll 4,000 people, many of whom speak little English and would have trouble working through health insurance.

“People may not be able to [enroll in insurance] because we have to cut our services,” Deng said. Now, “people will just have to rely on themselves and be able to figure it out on their own,” Deng said.

Pogue said Texas’ massive size and sparse geography means that with only two organizations receiving navigator funding, hundreds of counties will go without anyone to advertise health insurance to marginalized populations.

“Some folks — probably most folks — need somebody to sit next to them, hold their hand, answer questions,” she said.

Census figures show Texas’ 17.3 percent uninsured rate was the highest in the country in 2017 — an increase from its rate of 16.6 percent in 2016.

To fight these statistics, the East Texas Behavioral Healthcare Network would send representatives funded by the navigator program into rural communities across 80 counties, where they ran booths at health fairs and community events and ran ads on billboards and over the radio.

“They did everything from get people basic information about the health care marketplace all the way to helping them get fully enrolled, and working as an advocate for people who need insurance — people who came back year after year,” said the network’s business manager, John Bonner.

Texas runs an initiative, the Community Partner Program, that trains nonprofits, churches and other groups in offering outreach on Medicaid and the Children’s Health Insurance Program.

But Pogue said that because that program doesn’t offer funding, “you might get different levels of help based on whether they have trained volunteers,” she said.