Jonathan Gruber

Jonathan Gruber Embraced Misleading the Public About Obamacare Even While It Was Still Being Debated

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MIT

In the week since video surfaced of Obamacare architect Jonathan Gruber saying that "lack of transparency" and "the stupidity of the American voter" were critical to passing the health law, two more videos of Gruber making statements with similar themes or tones have received attention.

Both clips reveal a gleefully dismissive attitude toward public concerns about the law, and offer a telling reminder of the attitude that played a crucial role in shaping and selling the law to the public. 

In the first video, recorded in March of 2010, just a few days before the law would pass the House, Gruber argues that the public does not really care about the uninsured. What it cares about is cost control. Therefore, he says, the law had to be sold on the basis of its cost control.

Yet as Gruber admits in the video, the bill was not primarily focused on cost control—the bill "is 90% health insurance coverage and 10% about cost control." Indeed, the problem with cost control, he says, is that "we don't know how" to do it.

The primary quote. Via CNN:

"Barack Obama's not a stupid man, okay?" Gruber said in his remarks at the College of the Holy Cross on March 11, 2010. "He knew when he was running for president that quite frankly the American public doesn't actually care that much about the uninsured….What the American public cares about is costs. And that's why even though the bill that they made is 90% health insurance coverage and 10% about cost control, all you ever hear people talk about is cost control. How it's going to lower the cost of health care, that's all they talk about. Why? Because that's what people want to hear about because a majority of American care about health care costs."

Elsewhere in the same speech, Gruber says:

"The only way we're going to stop our country from being a latter day Roman Empire and falling under its own weight is getting control of the growth rate of health care costs. The problem is we don't know how."

Remember, this is what Gruber was saying as the law was still being debated. It didn't pass in the House, the critical step before hitting President Obama's desk, until more than a week later. And what Gruber was saying, even before the bill was law, was that supporters had intentionally emphasized parts of the bill that were relatively minor, and that were not certain to even produce their intended effects.

This is not lying, exactly; the bill did in fact include some attempts at cost control, although as Gruber said, it was unclear at the time if or how well they would work. And Gruber may well have been right that the public was more concerned with cost control than expanding coverage. But, especially in combination with the other video released this week, it indicates that Gruber believed that the law's advocates were not being completely straight with the public, that supporters of Obamacare were telling the public what they believed the public wanted to hear instead of giving them the full story, and that they were doing so on the understanding that telling the full story would make the bill impossible to pass.

What it shows, in other words, is Gruber openly embracing a strategy of messaging manipulation and misleading emphasis even while the bill was still being debated. If the public understood the bill clearly, he believed, they would reject it. It was more important to pass the bill. 

Another video, posted today by The Daily Signal, shows Gruber taking a similarly dismissive attitude toward public concerns about the bill.  At a meeting with the Vermont House Health Care Committee, Gruber is presented with a question about whether systems like those described in a report by Gruber and Harvard health economist William Hsiao, might result in "ballooning costs, increased taxes and bureaucratic outrages" as well "shabby facilities, disgruntled providers" and destructive price controls.

Gruber's response begin with: "Was this written by my adolescent children by any chance?" The Signal quotes two-term Vermont state senator and Reagan-adviser John McClaughry as saying that the question had been submitted "by a former senior policy adviser in the White House who knew something about health care systems."

Gruber's response is intended as a joke, and it reveals little about the health care law (the reforms in question are specific to Vermont). But it says plenty about Gruber, and the flippant, arrogant way he treats concerns and criticism. 

This is the person whom the White House relied on to help craft the bill; he was paid handsomely to model its effects (a fact he did not disclose, even when asked), and he was in the room when important decisions were made about how it would work. He claims to have helped write specific portions of the law himself. Gruber was not the sole architect of the law, but he was one of its biggest single influences on both its design and on how the media, which quoted him repeatedly, reported and understood the law. 

The White House and its allies are desperately trying to distance themselves from Gruber right now by downplaying his role in the law's creation. But the record of his involvement is clear enough: At The Washington Post, Ezra Klein has variously described Gruber as "one of the key architects behind the structure of the Affordable Care Act" and "the most aggressive academic economist supporting the reform effort." The New York Times in 2012 described his role as helping to design the overall structure as well as being "dispatched" by the White House to Congress to write the legislative text. Gruber's work was cited repeatedly by the White House, Democratic leadership, and the media.

So when he describes the thinking about how the law was crafted and sold to the public, it's worth taking note. This is the posture of one of the law's authors and chief backers. It's part of the spirit in which the law was created and passed. Gruber's ideas were embedded in the law's structure and language, and so was his attitude.