Jonathan Gruber claims Obamacare was passed due to the “stupidity of the American voter.” The MIT health economist, who was involved in drafting the Affordable Care Act, made that comment during a panel at last year’s Health Economist’s Conference. He was speaking about how a combination of the ACA’s complex wording and government opacity misled the American public about the true costs of the law.
Video of Gruber’s discussion recently surfaced, in which he has the following to say: “The bill was written in a tortured way to make sure [the Congressional Budget Office] 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.” Gruber’s essentially equating the individual mandate with a tax hike for some citizens, although he notes that the distinction is ultimately what allowed the bill to pass.
Gruber also blames the success of the individual mandate — the contested portion of the law that requires all citizens to buy in to the health insurance market or face fees — on a lack of government transparency. “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 said in the video.
Gruber’s forthright disclosures on the background of the ACA are not good news for a law that has been mired in controversy since it was first passed. Following months of lawsuits over the individual mandate and infamous struggles with Healthcare.gov, the open enrollment period for the federal exchanges is scheduled to begin again on November 15. The last thing the Obama administration needs is another reason for people to criticize the effectiveness of their health care law. It seemed like things were going to roll out more smoothly this time, but that was probably an unlikely estimation.
The scariest thing of all is that Gruber may be right about the stupidity of the American voter. The ACA was passed after being repeatedly muddled down by opposing parties in Congress. The resulting middle-ground, although different in both name and function, is not far from the tax-supported subsidized health care which members of Congress and many voters fundamentally opposed. Forbes writer Avik Roy sums it up simply: “The law’s complex system of insurance regulation is a way of concealing from voters what Obamacare really is: a huge redistribution of wealth from the young and healthy to the old and unhealthy.” Roy also argues against the provision requiring insurers to charge only three times as much for older customers than younger ones, claiming the country’s youngest generation is unfairly burdened with higher health costs that they don’t use themselves.
The phrase “stupidity of the American voter” has been isolated because it seems shocking and offensive, but in the larger context Gruber’s comments make sense. Obamacare was passed by a group of politicians outwitting those that opposed their ideals using workarounds in the legal language. Voters in Congress may not have been fully aware of what they were supporting, but perhaps they should have been. The larger American public was obviously less informed, kept in the dark with deceptive tactics. Yet the wording of the law helped what has in some cases become a tax hike circumvent a Congress that would otherwise have knocked it down. In many aspects, that could be viewed as an important political victory. Obamacare has helped many Americans gain access to affordable health care, and this country’s need for a stronger, more universal health care system was undeniable. There are issues, and it’s never good to hear that many of those issues stem from a lack of government transparency or deception of voters. As Gruber also says in the video after agreeing that transparency would ultimately have been the best option, “but I’d rather have this law than not.”