Tom Price reveals how Trump administration could dismantle much of Obamacare on its own

Department of Health and Human Services Sec. Tom Price has said President Donald Trump’s administration will work to dismantle key parts of the Affordable Care Act if Congress fails to act, although Price pledged he won’t do anything to hurt Americans.

Speaking on Sunday on ABC News’ “This Week” with Martha Raddatz, Price said “the current system is imploding” and that HHS has a “responsibility” to improve the health care system using the authority granted to it by the ACA.

“The responsibility of the department is to improve the health and the safety and the well-being of the American people, and we take that mission extremely seriously,” Price said. “Which is why we are so passionate about making certain that we’ve got a health care system, again, that works for patients.”

“So the ACA, Obamacare, had it stated 1,442 times — 1,442 times — ‘the [HHS] secretary shall,’ or ‘the secretary may.’ And what the previous administration did was made it so it was harder to care for patients and drove up the costs of coverage and drove up the costs of care,” Price added.

“We're going to look at every single one of those rules and regulations, all 1,442 of them, and determine: Does it drive up costs? Does it drive down costs? Does it help patients? Does it hurt patients? And when it drives up costs and hurts patients, we're going to move in the other direction,” Price said, indicating HHS could play a key role in reversing many Obamacare provisions in the future.

On Saturday, Trump announced on Twitter that if Congress doesn’t act soon on health care, he would effectively force them to by ending federal “BAILOUTS” — cost sharing reduction payments — given to health insurance companies.

“If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” Trump wrote.

If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!

— Donald J. Trump (@realDonaldTrump) July 29, 2017

On Friday, Trump suggested if Congress can't get a deal done, the federal government should "let Obamacare implode."

"3 Republicans and 48 Democrats let the American people down," Trump wrote on Twitter. "As I said from the beginning, let ObamaCare implode, then deal. Watch!"

3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!

— Donald J. Trump (@realDonaldTrump) July 28, 2017

Price seemed to walk back those threats when pressed by Raddatz on Sunday, although he also said “no decision has been made” about whether the federal government will continue make the cost sharing reduction payments.

“But this week, [Trump] said he was going to let [Obamacare] implode. Is that what he’s going to do?” Raddatz asked Price.

“No,” Price responded. “I think again the fact — that punctuates the concern that he has about getting this moved in the right direction. … This is a system, again, that’s not working for patients, and that’s what the president understands. That’s what he appreciates. That’s why he’s so passionate about making certain that he does all that he can to get this repealed and replaced with a system that works for patients.”

If Congress fails to replace Obamacare, it’s possible the Trump administration could effectively eliminate much of the law in the way Price described in his interview with Raddatz, by rolling back many of the costly regulations, refusing to enforce the individual mandate and granting states significant flexibility in how they manage their health care systems. However, without a new law, those actions could be reversed by another administration in the future, and the reforms that could be instituted would be relatively limited compared to what a law passed by Congress could accomplish.