Don't wait on Congress to start dismantling ACA, conservative groups tell Tom Price

Tom Price speaking
With Congress moving slowing on its ACA repeal effort, the pressure from the right is mounting on HHS Secretary Tom Price to chip away at the law through regulation. (Mark Taylor/CC BY 2.0)

Frustrated with Congress' slow march toward repealing and replacing the Affordable Care Act, some conservative groups are asking federal health officials to take a larger role in chipping away at the law through regulation.

In a letter (PDF) sent Friday to Health and Human Services Secretary Tom Price, Freedom Partners and Americans for Prosperity—both of which are affiliated with the Koch brothers—urged Price to launch “Phase II” of Republicans' three-prong ACA repeal strategy.

The first phase of the strategy is the passage of the American Health Care Act, which has passed the House and is currently being considered by the Senate. The next two phases, providing “regulatory relief” from the ACA and enacting additional legislation, were meant to follow.

But the Senate’s effort to come to consensus on its own version of healthcare reform may be a drawn-out process. In fact, Sen. Richard Burr, R-N.C., said Thursday that he doesn’t think the chamber is likely to pass a comprehensive healthcare plan this year, the Wall Street Journal reported (sub. req.).

Thus, the two conservative groups want Price to step up and wield his regulatory power.

“We’re asking him to take these steps now rather than waiting for Congress to pass legislation,” Americans for Prosperity President Tim Phillips said during a media call.

In their letter, the groups outlined five actions they want HHS to take that “do not depend on, and should not wait for” the passage of the AHCA.

One suggested step would be to ease the ACA’s medical loss ratio requirement, because under the current provision, “insurers are forced to either hike insurance premiums to meet the minimum threshold or exit the marketplaces,” said Freedom Partners Vice President of Policy Nathan Nascimento.

And if HHS stops limiting short-term insurance plans to three months, he said, it “would provide Americans with more choices of the type of coverage they can select.”

The rest of the groups’ suggestions included:

  • Loosening the ACA’s essential health benefits requirements
  • Expanding the list of ACA regulations of which states can opt out using 1332 waivers
  • Relaxing the ACA’s minimum actuarial value rule

Under Price, HHS has already encouraged states to apply for waivers to revamp their Medicaid programs and to set up high-risk pools or reinsurance programs to stabilize their individual marketplaces.

His agency is also taking aim at the ACA’s controversial contraceptive coverage mandate, as a recently leaked draft rule would expand the number of companies that can opt out of the requirement. That move, though, received considerable blowback from those worried it would erode women’s access to affordable healthcare.