Tom Price ducks questions about promoting Obamacare exchanges in 2018

Health and Human Services Secretary Tom Price hedged questions Wednesday as to how much the HHS would do to prop up the Affordable Care Act ahead of insurers facing a deadline to submit their premium rates for 2018 open enrollment.

Since House Speaker Paul Ryan last week pulled the American Health Care Act for lack of needed votes to pass the GOP plan, President Obama's ACA remains intact.

House subcommittee Ranking Member Rosa DeLauro of Connecticut on Wednesday wanted Price to make a commitment to the ACA remaining the law of the land.

"So long as the law is on the books, we at the department are obliged to uphold the law," Price said during the HHS budget hearing before the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies.

The administration's budget proposes an 18 percent cut to the department.

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Price stopped short of committing to promote the ACA through advertising.

The Office of the Inspector General is investigating HHS for halting advertising for Healthcare.gov during the last week of open enrollment last year, according to DeLauro, who wanted assurances that Price would maintain or expand funding for 2018 open enrollment operations.

"Those questions depend on the outcome of processes where this is the first step in appropriations process," Price said.

DeLauro also wanted assurances that Price would enforce the ACA's individual mandate. Insurers have said that without it, premiums would jump by 20 percent, she said.

"This side is extremely important because premiums have risen," Price said. "We've met with many insurers who tell us they're extremely concerned about the exchange and individual market."

Many insurers have left the ACA market due to financial losses. But insurers still in the exchanges said they are looking for resolutions to marketplace issues before they commit to remaining in the market in 2018. They are quickly facing a deadline -- April in some states and June for the federal market -- to submit their premium rates.

[Also: Humana to exit exchange business in 2018]

Aetna has said it would announce by April 1 whether it would remain in the four states where it currently sells coverage, according to NBC. Aetna lost $450 million last year on its exchange product.

Nothing has changed since the fourth quarter, Aetna said in a statement Wednesday.  The insurer is not entering any new ACA markets in 2018 and will continue to evaluate where it currently has a presence, Aetna said.

Anthem is in the ACA market in 14 states.

Anthem CEO Joseph Swedish said that without significant changes, Anthem would withdraw from the ACA market.

"As I have said publicly, without significant regulatory and statutory changes to the individual market, we will begin to 'surgically extract' Anthem from that market beginning in 2018," Swedish said in a March 9 letter to two House committees that approved the Republican's AHCA.

Molina Healthcare is evaluating state-by-state whether to continue operating in the nine states where it offers an exchange product: California, Floridan, Michigan, New Mexico, Ohio, Texas, Utah, Washington and Wisconsin, according to CEO Mario Molina, MD.

Molina said a decision will also be based on whether certain issues are resolved.

"Our position is that numerous issues currently exist with the marketplace that, unless addressed, put our participation in the marketplace at risk," Molina said. "In order to stabilize the program, we believe that the federal government must implement four key elements. First, the flaws in the risk transfer methodology must be addressed now. Second, the federal government must continue to provide cost-sharing reductions and premium subsidies. Third, there must be a strong incentive for individuals to purchase health insurance. Lastly, there must be stricter validation of eligibility for the special enrollment period."

Twitter: @SusanJMorse