Jonathan Gruber, one of the central architects of the Affordable Care Act, apologized Tuesday on Greater Boston for some of the controversial remarks he made in a video that recently went viral. During a 2013 panel discussion, he said the law was deliberately drafted to ensure the health care mandate would not be classified as a tax by the Congressional Budget Office. What he said next caused an uproar.
"If CBO scored the mandate as taxes, the bill dies. OK? So it's written to do that. In terms of risk-rated subsidies, if you had a law which said 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. OK? 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 to get the thing to pass."
"I apologize for the terms I used," Gruber told Emily Rooney. "I expressed myself very poorly."
Gruber said the point he was trying to make was that a more sensible way to create the federal law was to copy what was done in Massachusetts.
"There was one very important difference," he said. "In Massachusetts, we actually gave poor people money…to get health insurance. At the federal level, we couldn’t classify it as spending. That’s too politically unpopular."
As for the Affordable Health Care act’s future, Gruber said Congressional Republicans won't try to change any of the fundamentals, such as the insurance regulations that ban discrimination or the individual mandate nor the subsidies. Instead, he said they would go after the medical-device tax and employer mandate, which he estimated bring in a total of more than $130 billion in revenue.
"The much bigger threat is the Supreme Court case," said Gruber. "The Supreme Court case does attack a fundamental pillar of the law…. It says that the plaintiff’s claim, through a misreading of the law, that states that don’t run their own exchanges shouldn’t deliver subsidies to people, which is patently at odds with what the law is trying to do."
Gruber said the Affordable Care Act relies on people getting subsidies and would unravel without them.
"This comes to the master strategy of the Republican party, which is to confuse people enough about the law so that they don’t understand that the subsidies they’re getting is because of the law," he said.
“There are now eight million people getting subsidies. The number of uninsured in America is down by 10 million people. You’d think these people would be standing up shouting. I think they just don’t understand it’s Obamacare."
