Economist Jonathan Gruber has become a household name in the nation's capital and the media for saying that Democrats disguised unpopular provisions of the healthcare reform bill in order to win Congress' approval. Yet his comments didn't reveal anything about the substance of the 2010 Affordable Care Act that the public didn't already know. Rather, they betrayed Gruber's deep cynicism about the legislative process and the “stupid” American electorate. For someone who supposedly had a front-row seat, Gruber missed how well the months-long debate over the act conveyed what it would do and why.
Gruber, a professor at the Massachusetts Institute of Technology, helped the Obama administration develop its healthcare reform plan by modeling the likely effects of various provisions. In recent months, opponents of the law have unearthed recordings of Gruber telling audiences in 2011 and 2012 that lawmakers wrote the law in a needlessly complex way to hide the fact that healthy individuals would be required to cover more of the cost of insuring the sick, and that a tax on high-end insurance plans would eventually apply to all employer-sponsored policies.
There's no defending the sort of end-justifies-the-means tactics described by Gruber. The comments reaffirmed the long-standing Republican belief that Obamacare became law only because its sponsors lied about its provisions, such as the grandfather clause that would let people keep the insurance plans they liked. Of course, Republicans made their own ridiculous assertions about “death panels” (that don't exist), rationing of care (that is explicitly prohibited) and a “government takeover” (that somehow managed not to nationalize insurers, hospitals or doctors).
Happily, we live in an era of exceptional access to information by and about government, enabling anyone who's paying attention to suss out hidden agendas. The costs and taxes that Gruber said lawmakers were trying to conceal? They were discussed openly by the Congressional Budget Office and right-of-center think tanks, among many others. As a result, the central issues in healthcare reform have long been clear to the public regardless of the cloud of spin: whether to provide subsidized healthcare to more Americans who can't afford it, to make coverage available to more sick people by sharing more of the cost with everyone else, and to slow the increase in costs by promoting preventive medicine and higher quality care. Rather than dwelling on the cynicism of insiders such as Gruber, lawmakers should focus on how the act is actually performing and what might be done to improve it.
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