The Trump administration will continue enforcing Obamacare and won’t nix the law’s individual mandate requiring Americans to get coverage, the health secretary told Congress on Wednesday.
Health and Human Services Secretary Thomas Price said that as long as Obamacare is the law of the land, he’ll enforce it as written — though he declined to say whether President Trump will personally sell the program the way former President Barack Obama did. Mr. Price also would commit to coming up with more cash to keep the law afloat.
“So long as the law is on the books, we at the department are obliged to uphold the law,” he told House lawmakers at a hearing called to scrutinize Mr. Trump’s proposed budget cuts.
Mr. Price said it remains to be seen whether Mr. Trump will continue to fund Obamacare’s federal website and call centers, saying the budget process just got started.
He also distanced himself from the January decision to yank up to $5 million in ads meant to bolster enrollment ahead of the deadline, saying it happened before he got to the agency.
“What we’re committed to is making certain that the American people have access to affordable coverage,” Mr. Price said.
That answer frustrated Democrats, who said they wanted a clearer sense for how committed to Obamacare the Trump administration will be now that House Republicans’ repeal-and-replace effort has stalled.
After Friday’s fiasco, which saw House Speaker Paul D. Ryan schedule a vote but then cancel it at the last moment when it became clear he didn’t have enough support, the GOP has sent mixed signals.
Mr. Trump and Mr. Ryan both initially said they were moving on, though other lawmakers said they would like to take another quick stab at changes.
A pair of Senate Republicans filed a bill Wednesday that would let Americans use their Obamacare subsidies on any plan in the individual market if they do not have any options on the exchange in 2018 or 2019.
It also would let people duck the individual mandate tax if no insurers offer plans in their area.
Bill sponsors Sens. Lamar Alexander and Bob Corker, both of Tennessee, said 40,000 Knoxville residents will have no options on the exchange next year unless an insurer steps in to replace Humana, which decided to withdraw from Obamacare entirely in 2018.
“At some point, on behalf of the American people, Congress and the administration have to resolve the issues that are driving up health care costs, limiting choices and causing the exchange market to spiral downward,” Mr. Corker said.
Democrats told Mr. Trump on Wednesday they’re ready to negotiate fixes, but on one condition — stop trying to kill Obamacare outright.
“If they’re going to renew their efforts toward repeal, we’re not going to participate in that,” Rep. Diana DeGette, Colorado Democrat, said in a speech at the National Press Club in downtown Washington.
She outlined a set of principles that go beyond ideas that Republicans have rejected as an expansion of Obamacare, such as establishing a government-run “public option” to compete with private plans in the insurance marketplace.
For instance, the GOP is worried about out-of-control prescription drug prices, and it might be willing to invest in preventive care for rural residents, Ms. DeGette said.
Conservatives will likely balk at any efforts that increase the federal footprint in health care, though Ms. DeGette is betting that moderate Republicans will be willing to spend a little now to reap benefits later on.
“I’m not going to win that argument with the Freedom Caucus,” she said after her event. “But some of the other ones are realizing the advantage of investing money for prevention early on so you don’t have those huge expenses.”
For now, Obamacare’s supporters are asking Mr. Price to bolster what’s in place, saying any attempt to speed the law’s demise would be reckless and unacceptable.
“The health care of the American people is not a political bargaining chip,” said Rep. Rosa L. DeLauro, Connecticut Democrat. “The idea that the president of the United States would intentionally undermine the health and the financial security of millions of Americans for personal political gain, in my view, is malicious.”
Mr. Price refused to say whether the Trump administration will fund cost-sharing payments that are critical to making Obamacare work, particularly for low-income enrollees, saying he’s now a litigant in a lawsuit that House Republicans filed against Mr. Obama.
“I’m a party to that lawsuit, and I’m not able to comment,” he told lawmakers.
Pressed on whether he plans to maintain Obamacare’s essential health benefits, which cover things like maternity care and mental health, Mr. Price said he would uphold the law, though “individuals ought to be able to select the kind of coverage that they want, not that the government forces them to buy.”
Policy analysts say Mr. Price cannot change the essential benefits without Congress, though he might have leeway to limit services within each category.
The secretary hinted at his own powers on Wednesday.
“Fourteen hundred and forty-two times the [Affordable Care Act] said, the secretary ‘shall’ or the secretary ‘may,’” Mr. Price told Rep. Andy Harris, Maryland Republican.
The back-and-forth underscored the uncertainty around Obamacare, which extended coverage to more than 20 million but failed to attract young and healthy people into its exchanges. As a result, insurers raised their rates or fled the market. Some counties might not have any options at all by 2018.