Your right to choose restored by health mandate repeal

Your right to choose restored by health mandate repeal
© Hill Photo Illustration/Garrett Evans

On Dec. 22, President TrumpDonald TrumpOmar, Muslim Democrats decry Islamophobia amid death threats On The Money — Powell pivots as inflation rises Trump cheers CNN's Cuomo suspension MORE signed the Tax Cuts and Jobs Act (TCJA) into law. This legislation simplified and reduced taxes for job creating corporations and millions of Americans. In addition, one of its key provisions removed the individual mandate penalty of the euphemistically-labeled “Patient Protection and Affordable Care Act” (ACA).

This effective repeal of the mandate was urged by President Trump, who has made restoring consumer choice in health care, which was all but eliminated by the costly, regulation-laden, one size fits all ObamaCare, a cornerstone of his administration’s health-care reform policy.

Many Democrats, health industry interests and policy makers, including, according to a report in yesterday’s issue of USA today, former Health and Human Services (HHS) Secretary Tom PriceThomas (Tom) Edmunds PriceWant to evaluate Donald Trump's judgment? Listen to Donald Trump Former Georgia ethics official to challenge McBath A proposal to tackle congressional inside trading: Invest in the US MORE, have criticized repeal of the individual mandate. This hostility is misplaced.


Dr. Price, who resigned as HHS Secretary amidst controversy last September, repeatedly referred to repeal of the mandate as the Trump Administration’s “top priority” during his brief tenure. Now in the private sector, Price appeared to reverse himself when on Tuesday he told a group of health-care executives that he no longer favors repeal of the individual mandate.

He expressed the concern that repeal will increase costs and hurt ObamaCare risk pools. “There are many, and I’m one of them, who believes … 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 reportedly said.

Recall that the individual mandate, which the TCJA put to rest beginning next year, is a congressionally imposed, Internal Revenue Service collected penalty on Americans who choose not to purchase government-approved health insurance.

Note the emphasis on the term “government-approved.” Importantly, application of this federal sanction isn’t confined to those who choose not to purchase insurance at all, which alone would be odious. Instead, congressional Democrats also inflicted the punishment on people who buy health insurance plans the features of which these same legislators did not approve.

In fact, excellent alternatives to the extremely expensive, very limited number of ObamaCare exchange plans are available, or at least will be, when the Trump Administration finalizes a proposal reversing a 2016 Obama rule that gutted the usefulness of a type of policy known as short-term, limited duration insurance.

What Price is really arguing is that the federal government should deploy the power of the United States to coerce self-employed individuals, small business people and the unemployed into buying grossly overpriced health insurance they do not want and cannot afford.

According to him, if the federal government does not do this, costs will go up for those whose care he wants subsidized, namely unfortunate individuals living with chronic diseases or facing serious illness.

What he fails to explain is why hapless unemployed men and women and financially strapped small businesspeople should disproportionately bear the costs of this care via purchase of a deficient and outrageously priced product. Should not everybody pay for what is truly a societal responsibility?

Even Dr. Price’s concern about the potential for increased costs on the ACA exchanges seems overblown. According to the non-partisan Congressional Budget Office (CBO), after repeal of the individual mandate insurance markets, “would continue to be stable in almost all areas of the country throughout the coming decade.”

Yes, the CBO estimates there may be some increase in premiums, but for many individuals who purchase exchange plans higher rates will be offset by additional federal subsidies. In reciprocation, millions will be able to avoid the exorbitant costs of ObamaCare plans entirely by obtaining more reasonably priced policies that better meet their needs, thus likely making this a net win for consumers.

Finally, due to the Rube Goldberg like convolutions of ObamaCare, repeal of the individual mandate is predicted to save $300 billion to $400 billion in federal ObamaCare subsidies over the next decade, as people move to non-ACA insurance. This is one more argument supporting repeal and the correctness of Dr. Price’s previous position.

The individual mandate took away our freedom to make our own health-care decisions, which was in large measure why it was so unpopular. By repealing the individual mandate, President Trump and congressional Republicans are giving us back this freedom, restoring consumer choice to the individual health-care marketplace and taking a substantial step toward restoring fairness, a problem inherent to the individual mandate that could not be repaired.

Dr. Roger D. Klein is a member of the Regulatory Transparency Project on health care. He is a former adviser to the FDA and HHS. Roger graduated from Yale Law School and completed his post-graduate medical training at Yale Medical School.