Friday, July 25, 2014


It's been argued that shrewd Republicans -- including the shrewd and extremely politicized right-wing bloc on the Supreme Court -- don't want to overturn the Affordable Care Act at this point, because pushing millions of people off the healthcare rolls would do serious harm to the GOP at the polls. That may be true -- it may be true of the GOP leadership, and it may be true of John Roberts and his cronies.

But if it is true, then what we're seeing is another conflict between the extremely-but-not-insanely-conservative "mainstream" branch of the GOP and the just-let-it-burn crazies, led by the Koch brothers. The Kochs are not young men. They don't have much time left to fundamentally transform America into a New Gilded Age state with a tiny social safety net. They want the ACA gone now.

So they've got opposition researchers turning over every rock they can, looking for evidence that the authors of the ACA intended to provide health insurance premium subsidies only in states that set up their own insurance exchanges, as one part of the bill states (contradicting other passages in the same bill). And they've got a coup, because somebody found this in Minute 31 of an obscure 2012 talk by MIT economist Jonathan Gruber, who worked on the development of both Romneycare and Obamacare:
A video of the presentation, posted on YouTube, was unearthed tonight by Ryan Radia at the Competitive Enterprise Institute, a libertarian think tank which has participated in the legal challenge to the IRS rule allowing subsidies in federal exchanges. Here's what Gruber says.
What's important to remember politically about this is if you're a state and you don't set up an exchange, that means your citizens don't get their tax credits -- but your citizens still pay the taxes that support this bill. So you're essentially saying [to] your citizens you're going to pay all the taxes to help all the other states in the country. I hope that that's a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges. But, you know, once again the politics can get ugly around this. [emphasis added]
If that was Gruber's understanding, it contradicts what other architects of the law have said, and what he's said at other times -- but still, this is a big find, and the right-wing media is all over it.

This was found by a guy at the Koch-funded Competitive Enterprise Institute and published on the blog of the Koch-funded Reason magazine, in support of a lawsuit pushed by the partly Koch-controlled Cato Institute.

The Kochs and their bleeding-edge wingnut billionaire allies can't wait. They're out to destroy Obamacare no matter what the consequences to the GOP in 2016. They'll deal will the elections later. For now, their goal is to win this war. And it's total war.


Now, regarding what Gruber says: I've appended the video below, and you can see if you go to Minute 31 that this isn't a James O'Keefe disortion -- Gruber's words aren't being taken out of context.

On the other hand, Gruber was also the coauthor of a series of assessments of the law's impact on states, written for Gorman Actuarial, LLC, in 2011, after the law passed. I certainly haven't read every word of the 67-page Maine report (PDF), or all 56 pages of the Wisconsin report (PDF), but I see no attempt whatsoever to assess what happens to premium subsidies in these states if state exchanges aren't established -- even though both states had elected tea party governors a year earlier. (A year later, both Maine and Wisconsin would announce their refusal to set up state exchanges.)

Why would Gruber put his name on a lengthy analysis of Obamacare's impact on these states that didn't assess a scenario he thought was a serious possibility? It makes no sense.

After the Halbig decision came down, Gruber said this:
Literally every single person involved in the crafting of this law has said that it's a typo, that they had no intention of excluding the federal states. And why would they? Look, the law says that people are only subject to the mandate if they can afford insurance, if it's less than 8 percent of their income. If you get rid of these subsidies, 99 percent of the people who would get subsidies can no longer afford insurance, so you destroy the mandate. Why would Congress set up the mandate and go through all that political battle to allow it to be destroyed?
Right-wingers would tell you that Gruber was told that the Liberal Politburo said he'd become an unperson and be sent to a reeducation camp if he didn't say that now. Do you believe that? Go to the link and watch the clip I transcribed. He sounds quite sincere to me -- and extremely angry at right-wingers' attempts to destroy this law.


Victor said...

If they don't set up armed guards around the Koch Brothers burial place, they should at least set-up a toilet-paper dispenser nearby, for all of the people in line who can't wait to piss and shit on their graves.

Chris Andersen said...

If we can reasonably suppose that a law can have a typo like the clause in dispute then it is not unreasonable to assert that one person in one talk could have a momentary brain fart and characterize the law in a similarly incorrect fashion.

Steve M. said...

Which is precisely what Gruber now says happened.

aimai said...

It is literally obscene for these people to try to use Jonathan Gruber, who has work tirelessly and sincerely for the cause of expanded healthcare here in MA and in the Country as a whole, as some kind of crazed "gotcha" for this bizarre theory which, even if it were true would simply reqire revising the law not gutting it. Even if it were true, in some existential sense, that either a mistake was made or a deliberate miscalculation happened so what? Legislation this complex is always amended when new circumstances arise or we have more information. This is especially true in the case of legislation trying to deal wiht medical issues because medical practice and the needs of the population are always a moving target (Insurance companies and medical providers recalculate and rebid their contracts every year, new practices arise and old ones are discarded).

At any rate nothing Gruber said in the 2012 interview is dispositive--it doesn't prove anything and it doesn't mean anything. Its just more obfuscation being circulated by trolls. I know that because a troll already brought it to our attention, with faux sincereity, over at LGM yesterday pretending that he himself had been "searching" online for some "true facts" and a "sincere" person although after finding out that Gruber has struck back against the borrowing of his name and words for the anti health care cause this poster then declared Gruber a "partisan" who was no longer "neutral."

The whole thing makes me retch.

Scott Lemieux said...

It's not a coup; it's just another addition to Mount Glibertarian Bullshit.

Yastreblyansky said...

The troll must have had to search pretty hard. I've half-listened for hours this morning, when I should have been working, to Jonathan Gruber addressing gatherings in January 2012 (he was launching a mass-market book on the ACA) trying to find out if he said anything similar on any other occasion at the time, and I'm pretty sure he didn't. I also think the questioner's voice on the clip sounds edited, so I wouldn't bet there is no O'Keefery --like for instance suppressing an original question that could have directly addressed the original hypothesis as introduced by Jonathan Adler and Michael Cannon in WSJ November 16 2011. In any case Adler and Cannon really did introduce the idea in November 2011, and that's why Gruber was even able to address it. It wasn't ever part of his understanding of what the ACA is.

Steve M. said...

Scott, the cons run the country, no matter who gets elected. Glibertarian bullshit is their 2+2=5.

RoadScholar said...

Politically-motivated activist judges. Here's how I see it, and I'm sure the hight court will too: The law said that if States don't set up an exchange, the Feds will set up one FOR them. Not 'applicants will have to use the Federal exchange.' One set up FOR the State. It's a State exchange... using the providers IN THAT STATE, for the people OF THAT STATE. It will obey insurance regulations OF THAT STATE.

So the subsidies are valid. period.

Joseph Nobles said...

The Gruber quote is indeed being taken out of context. No less than the American Conservative website has shown this now:

Gruber says right before all this: " “Yes, so these health insurance exchanges . . . will be these new shopping places and they’ll be the place that people go to get their subsidies for health insurance. In the law it says if the states don’t provide them the federal backstop will. The federal government has been sort of slow in putting up its backstop in part because I think they want to sort of squeeze the states to do it.”

In other words, the federal backstop (exchanges) will provide the subsidies. But the feds were dragging their heels as a way to encourage states to do the work themselves.

This is James O'Keefe-level ratf**kery at work, and it's caught a lot of people because of the DC Circuit decision.

Eric said...

Just curious: can any of you provide evidence from the time that Obamacare was passed that subsidies would be provided to those who didn't sign up through a State exchange? Anything at all?

Nope. Nobody - including Gruber - suggested subsidies would be available through a federal exchange. In fact, sensing a political backlash, the Obama Administration told the IRS to ignore the law as written.

Show me evidence - from when the law was implemented - that subsidies through the Federal exchange was available. Where is it? Please don't give me your fanciful four-years-after-the-fact interpretation of plain language.

Joseph Nobles said...

Eric, Gruber said just that immediately before the comments right wingers are all worked up over. I quoted him right before your comment.