Health and Human Services Secretary Alex Azar took several swipes at Obamacare on Thursday, blasting the healthcare law as an example of government over-regulation that resulted in more expensive options for patients and disincentives to grow income.
He singled out the exchange program where people purchase private healthcare coverage with help from the government, as well as the Medicaid expansion, which changed Medicaid from a program that covered certain populations, including people with disabilities and pregnant women, and moved to add coverage for anyone making less than $16,000 in most states.
Azar was delivering a speech that focused on free-market principles at the conservative Heritage Foundation, an organization that has informed much of the Trump administration’s policies on healthcare.
Obamacare, he said, “imposed a new tax or regulation, or sometimes both, on just about every moving part in our healthcare system.”
The exchanges had faced too many restrictions that made it unattractive to young people, causing them to drop out, and for older people to be left behind paying more, he said. The agency’s research has shown that people who do not receive subsidies under Obamacare, meaning anyone making more than roughly $48,000 a year, have dropped out of the marketplaces because they cannot afford the premiums.
“The only factor keeping the individual markets alive is the tens of billions in subsidies supplied directly to insurers each year,” Azar said. “The fundamental flaw of the Affordable Care Act is that it narrowed the competition for insurance options and laid down heavy-handed controls on the prices that could be charged.”
He also addressed the Medicaid expansion, noting that the expansion population received a larger share of federal dollars than the traditional Medicaid population. The federal government contributes a higher percentage to the Medicaid population covered under Obamacare, including able-bodied adults, than it does toward people who have historically qualified for Medicaid. In comparison, the federal government pays for roughly 60 percent of coverage for the traditional population.
“Supporting legislation to undo these perverse incentives is a priority for this administration,” he said. In the meantime, he touted efforts by the administration to obligate certain beneficiaries work or train for work in order to stay enrolled in the program.
“There is no reason they necessarily couldn’t be working,” he said later during a question and answer portion of the event, referring to people who are not disabled and don’t have children.
Later during the program, he said he believed it was a problem for people to feel that they needed to keep their incomes below $16,000 in order to keep qualifying for Medicaid.
“It should never be the case that you make more money by not working than working,” he said.
