The Truth About The Affordable Care Act

Did you read about Senator Ted Cruz's latest claim that Obamacare was enacted as part of a scam on the American people?

"This 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 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."

Oops, my mistake.  The statement was actually by Jonathan Gruber, one of the "architects" of Obamacare who then went on to say "I wish . . . we could make it all transparent, but I'd rather have this law than not". 

Noted right wing extremist Howard Dean said of Gruber's remarks:

The problem is not that he said it–the problem is that he thinks it. The core problem under the damn law is it was put together by a bunch of elitists who don’t fundamentally understand the American people. That’s what the problem is.

[UPDATE, Nov 14]  By the way, look at Gruber's reference to the importance of CBO scoring.  Gruber knows what he's talking about since the input data CBO used for its analysis was generated by Gruber's own economic model of the ACA for which he was hired by the White House, a hiring that both Gruber and the White House went out of their way to hide from the public at the time of the debate over the bill!  Keep that in mind the next time Obamacare supporters try to downplay Gruber's role.  Not surprisingly Nancy Pelosi is already playing this card, just yesterday claiming  "I don't know he who is" even though she was citing Gruber as a reputable, supposedly independent expert, in supporter of the ACA back in 2009.

[UPDATE, Nov 16] And here's another example of rewriting history from Connecticut Senator Chris Murphy (D-Callow Youth) tweeting "It's sad to me that good political journalists are spending so much time on these irrelevant comments by this guy Gruber."  Senator Murphy, who recently whined about how hard it was to do Obamacare since "we were reordering one-sixth of the economy", attempts to deftly separate Democrats from the now six and counting Gruber videos by referring to "this guy Gruber" to which Jake Tapper of CNN responds "respectfully, it's sad to me that some politicians would claim the comments are irrelevant".

[UPDATE, Nov 16]  Don't believe anyone who tells you that Gruber was not integral to the passage of the ACA and the President's strategy for selling it to the American people.  National Review Online links to a 2010 Daily Kos piece(!) pointing out that Gruber was awarded a sole source contract by HHS which used some eyebrow raising language to justify not putting the contract out to bid:

The Department of Health and Human Services (DHHS), Assistant Secretary for Planning and Evaluation (ASPE), intends to negotiate with Jonathan Gruber, Ph.D. on a sole sources basis for technical assistance in evaluating options for national healthcare reform. The basis for restricting competition is the authority of 41 USC 253(c)(1) 106-1(b) because there is only one responsible source and no other supplies or services will satisfy DHHS requirements.The anticipated contract period will be eight months. [Emphasis added].

Dr. Gruber is uniquely positioned to provide the analytic work ASPE requires based on over 15 years of experience in health care and health policy. Dr. Gruber is a recognized expert in health policy in economics including being widely published in peer-reviewed academic and health policy literature on the effects of changes in health benefit designs on the cost of enrollment in health insurance. Moreover, in order to estimate the impacts, Dr. Gruber developed a proprietary statistically sophisticated micro-simulation model that has the flexibility to ascertain the distribution of changes in health care spending and public and private sector health care costs due to a large variety of changes in health insurance benefit design, public program eligibility criteria, and tax policy. This model has been used for other health reform proposal. Finally, Dr. Gruber’s ongoing work with ASPE, using these proprietary models to help inform the Office of Health Reform, strongly positions him to meet HHS’ requirements the most efficiently, which is a key requirement in order for well-developed legislative proposals to be put forth for Congressional consideration as soon as possible. 

[UPDATE, Nov 18]  If you're exhausted from watching Gruber videos or just want a quick summary watch this two minute video which THC believes accurately presents the current state of play:

Remember back a year ago when the Democrats called those folks who were having their policies cancelled because of Obamacare "stupid" for having purchased the policies in the first place?  Turns out that the Democrats also believed that their own voters were so "stupid" they could be fooled into supporting the passage of Obamacare!  So apparently everyone is "stupid" except for the brilliant thinkers who put the ACA together and those, like THC, who opposed it.  We may not be "smart" but at least we are "non-stupid"!

Though some desperate Progressive supporters and media reporters (is there a difference?) have been coming up with tortured explanations to rationalize Gruber's statements, for those who actually followed the ACA debate in 2009-10 his statement is no surprise and there is no contextualizing away the three fundamental lies (or, as the NY Times prefers to call them, "incorrect promises") repeatedly told by President Barack Obama and his political supporters:

You can keep your health care plan if you like it!
Reality:  Millions of Americans have had their plans cancelled against their wishes and the Administration's own Department of Health & Human Services estimates that up to 93 million Americans may lose their insurance ultimately under the ACA.

You can keep your doctors if you like them!
Reality:  As millions of Americans have discovered, when you lose your existing insurance coverage you may also lose the doctors you like.

The average American family will save $2500 in premiums!
Reality:  At best a half truth.  Some of those who have policies and are now getting subsidized are paying less.  Of course that means someone is either paying more directly for insurance or indirectly via taxes.  Those who are unsubsidized are often paying more, in some cases much more and almost everyone has higher deductibles meaning that even if you are paying less in premiums you will pay more if you are actually sick.

All this goes to prove how "smart" Nancy Pelosi was when she told us we needed to pass the ACA in order to find out what was in it.

[UPDATE, Nov 14]  And who was the vigilant media reporter who uncovered the video?  Actually it was a Philadelphia investment advisor, Rich Weinstein who was motivated by his personal experience with Obamacare:

“When Obama said 'If you like your plan, you can keep your plan, period'—frankly, I believed him,” says Weinstein. “He very often speaks with qualifiers. When he said 'period,' there were no qualifiers. You can understand that when I lost my own plan, and the replacement cost twice as much, I wasn’t happy. So I’m watching the news, and at that time I was thinking: Hey, the administration was not telling people the truth, and the media was doing nothing!”

     (Prof Gruber)
Mr Gruber, who is also a tenured professor had MIT, is starting to establish a track record of blurting out the truth, albeit somewhat too late to influence the legislative process.  He was also recently in the headlines because of the litigation challenging the IRS determination that citizens in states that did not establish healthcare exchanges under the ACA were still eligible for federal subsidies despite the clear language in the statute limiting such subsidies for states that did not set up exchanges.  In its briefs government lawyers often cited Prof Gruber for the proposition, based on his extensive involvement in the drafting of the ACA (for which he was paid more than $400,000 by the Administration), that the intent of the law was to extend subsidies in all cases and that for the courts to find otherwise would undermine the purposes of the ACA.  Unfortunately, the government has now disappeared the Professor from its more recent court filings because it turns out that he gave a talk in January 2012 in which he thoroughly laid out the thinking behind differentiating between subsidies for the federal and state exchanges in a way that completely supported the interpretation of those who opposed the IRS determination!  For more detail read this and, by the way, could someone wake Paul Krugman up since just a few days ago he claimed that the entire dispute is about a "typo", an argument that the government isn't even making anymore. This issue is particularly timely since just last week the Supreme Court announced it will take up the challenges the IRS action in its current term.

[UPDATE, Nov 16]  It seems as though healthcare reform has been very, very good for Prof Gruber as he's apparently made at least $5.9 million since 2000 consulting for the Feds and state governments. 

All in all, the edifice of lies, "incorrect promises", and deception deployed in order to pass the ACA along with the arbitrary and illegal changes by the Administration in its implementation puts THC in mind of one of Instapundit's favorite phrases - it's Potemkin Villages all the way down!

[UPDATE, Nov 14] Even Ron Fournier, a reporter for National Journal, who "openly rooted for Obamacare's success" was prompted by the latest revelations to write:

He called you stupid. He admitted that the White House lied to you. Its officials lied to all of us—Republicans, Democrats, and independents; rich and poor; white and brown; men and women.

Liberals should be the angriest. Not only were they personally deceived, but the administration's dishonest approach to health care reform has helped make Obamacare unpopular while undermining the public's faith in an activist government. A double blow to progressives.

And so even I have to admit, as a supporter, that Obamacare was built and sold on a foundation of lies. 

Professor Gruber also made news when in response to growing concerns about income inequality and in light of his comments denouncing "winners of the genetic lottery" he volunteered to give up his tenure at MIT to be replaced by Boston residents chosen at random from the phone directory on an annual basis (satire alert).

For more on the fiasco of the ACA read THC's prior posts on this topic.