Former HHS chief Tom Price: Repealing individual mandate will harm ACA markets

Tom Price, MD, was a major supporter of repealing the Affordable Care Act (ACA) both in Congress and during his short tenure as President Donald Trump’s HHS Secretary. Since he left office, Republicans managed to impact the ACA in a major way by zeroing out the penalty for not being insured in their tax cut law, but Price said the move will increase premiums on the law’s health insurance exchanges.

“And there are many, and I’m one of them, who believes that that actually will harm the pool in the exchange market, because you’ll likely have individuals who are younger and healthier not participating in that market, and consequently, that drives up the cost for other folks within that market,” Price said during a speech at the World Health Care Congress.

Price had been opposed to the individual mandate, saying in July 2017 it was “actually driving up the cost for the American people in terms of coverage.” As a member of Congress, his ACA alternative would’ve eliminated both the individual and employer mandates in the law.

As HHS Secretary, Price spearheaded unsuccessful efforts to repeal and replace the ACA while taking action on the regulatory side to cut advertising for the ACA exchanges, limiting the open enrollment period and expanding exemptions to the individual and employer mandates—efforts that were labeled as “sabotage” by Democrats and other supporters of the law. His ability to impact the ACA ended when he resigned from HHS in September 2017 over his use of charter flights at taxpayers’

Major legislative changes to the ACA, Price said, would likely have to wait until after the midterm election. He guessed the Republicans in Congress may revive the Graham-Cassidy legislation focused on block granting much of the ACA’s funding for premium subsidies and Medicaid expansion. Otherwise, Price guessed states may ask the federal government for more flexibility on the ACA or take action on their own, such as instituting their own individual mandates.

“That kind of flexibility may be the wisest way to proceed from a public policy standpoint: to allow states the opportunity to figure out what works best for their citizens,” Price said.

His comments on repealing the mandate worsening the ACA’s risk pool seemed to acknowledge warnings from insurers and the Congressional Budget Office before the Republican tax cut law was passed. Democrats quickly seized on his comments to argue the expected increases in ACA premiums for 2019 should be blamed on Republicans.

“I’m glad to see former Secretary Price admit the truth, which is that families’ premiums are going up because President Trump and Republicans in Congress have spiked prices with their relentless, partisan health care sabotage,” Sen. Patty Murray, D-Washington, said in a statement. “People across the country are unfortunately going to start seeing higher rates being filed as soon as this week, and former Secretary Price’s comments make it absolutely clear who families should hold accountable—President Trump and Congressional Republicans.”