- Jonathan Gruber, an MIT economist and key architect of the Affordable Care Act, suggested in a recently-surfaced video clip that "the stupidity of the American voters" helped Obamacare pass.
- Gruber has since apologized for those remarks, saying he "spoke inappropriately."
- Gruber was in the spotlight earlier this year for a separate talk, where he suggested that states that don't set up exchanges also don't get tax credits — a key argument of plaintiffs in the new Supreme Court case against Obamacare.
- Gruber's larger point here is about the very odd ways the law had to be structured to avoid criticism — and that part still rings true.
Gruber: lack of transparency, "stupidity of the American voter" helped pass Obamacare
Speaking at last year's Health Economists Conference at the University of Pennsylvania, MIT economist Jonathan Gruber talked about how the Affordable Care Act passed. One of the things he argued there was a lack of voter interest, understanding and intelligence helped Obamacare become law. This is the relevant passage:
The bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If [CBO] scored the mandate as taxes, the bill dies. Okay, so it's written to do that. In terms of risk-rated subsidies, if you had a law which said that healthy people are going to pay in — you made explicit that healthy people pay in and sick people get money — it would not have passed...Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter, or whatever, but basically that was really, really critical for the thing to pass.
Gruber has since apologized for the remarks, telling MSNBC's Ronan Farrow that he "spoke inappropriately" in describing American voters as stupid, and that he "regrets having made those comments."
Obamacare really was written in a "tortured way"
Putting aside the controversy around the stupid voters comment, there is a real point that Gruber makes about the tortured ways the Affordable Care Act was structured in order to avoid criticism. This is true in the example Gruber picks out: that, in order for Obamacare to survive politically, legislators didn't want to call the individual mandate a tax. It's true elsewhere in the health law, too.
During the health reform debate in 2009, legislators strove desperately to keep the price-tag of the under $1 trillion. There's nothing special about a health overhaul that costs $900 billion or $1.1 trillion, but $1 trillion was the amount that seemed politically feasible to present as a price tag for the effort.
The effort to stay below a $1 trillion budget led to weird policy decisions such as waiting three years until after passage to start the insurance expansion. That meant the government spent less money over the 10-year time frame that CBO uses to figure out how much laws cost — but didn't really have much of a policy rationale behind it.
