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May 2, 2018

Price repeatedly spoke out against the ACA's individual mandate. Now, he's criticizing its repeal.

Daily Briefing

    Tom Price, an orthopedic surgeon and former HHS Secretary under President Trump, on Tuesday said he believes eliminating the Affordable Care Act's (ACA) individual mandate penalty "will harm … the exchange market."

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    Price, who resigned as HHS secretary in September 2017 amid federal investigations and growing criticism over his use of private planes for official business, made the comments at the World Health Care Congress. Price in the past has been critical of the ACA and has advocated for repealing the law's individual mandate. For instance, according to CQ Health, Price in July 2017 during an appearance on ABC's "This Week" said, "The individual mandate is one of those things that actually is driving up the costs for the American people in terms of coverage."

    Last year, after GOP efforts to repeal and replace the ACA failed, Congress passed and Trump signed a tax reform law that effectively eliminates the individual mandate penalty in 2019 by setting the penalty to $0.

    Price's comments on health reform

    In his remarks on Tuesday, Price said he and many others believe that eliminating the individual mandate penalty will "harm the (risk) pool in the exchange market," because "you'll likely have individuals [who] are younger and healthier not participat[e] in that market, and consequently that drives up the costs for other [people] within that market."

    Price said lawmakers should not have eliminated the individual mandate penalty since they did not also address other issues with the law by reforming or repealing the ACA. At this point, Price said he expects further action to amend or repeal the ACA likely will come through regulations instead of legislation. For instance, he said Medicaid and state innovation waivers provide a "great opportunity" for states to design health care to suit the needs of their residents.

    If Congress decides to take a legislative approach, Price said federal lawmakers likely will advance a measure similar to a bill introduced by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.)—which would repeal the ACA's employer and individual mandates retroactively to 2016 and would allow states to waive the ACA's health status and age underwriting protections, as well as the law's essential health benefits.

    Price also commented on a lawsuit  that claims eliminating the ACA's individual mandate penalty invalidates the entire ACA. He said, "I don't know what the court's going to do with that, but it is percolating out there and will move through and I suspect, be before the Supreme Court, if not in the next term, then the following term."


    Some observers said Price's comments show that Republicans were acting to undermine the ACA when they eliminated the individual mandate penalty.

    Sen. Patty Murray (D-Wash.) in a statement said, "I'm glad to see … Price admit the truth, which is that families' premiums are going up because … Trump and Republicans in Congress have spiked prices with their relentless, partisan health care sabotage."

    Brad Woodhouse, campaign director for Protect Our Care, said, "Now, one of the Trump administration's lead saboteurs has admitted the truth. Americans now have it straight from Tom Price: Republicans are responsible for upcoming rate hikes" (Dickson, Modern Healthcare, 5/1; Huetteman, Kaiser Health News, 5/1; Firth, MedPage Today, 5/1; CQ News, 5/1 [subscription required]).

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