Affordable Care Act's Unpopularity Helped Trump Win 2016 Election

What was Obamacare, in the end, but an arrogant overreach by an elite out of touch with the rest of America?


Richard B. Levine/Newscom

Call it the Jonathan Gruber election. Gruber is the Ford professor of economics at the Massachusetts Institute of Technology, in Cambridge, Massachusetts. He got his Ph.D. at Harvard. As a White House consultant, he helped to design Obamacare and was then caught afterward on videotape explaining its passage by talking about "the stupidity of the American voter."

Well, if anyone is "stupid" in this story, it's not the voters, but the academics that in their hubris designed an Affordable Care Act that became so unpopular that it became a decisive factor in Hillary Clinton's defeat. These economists and health care experts—Jonathan Gruber and people like him—have fancy graduate degrees, but they designed a law whose results aren't exactly making them or the politicians they advised look like geniuses.

Asra Q. Nomani, a Muslim woman immigrant who voted in Virginia for Donald Trump, explained in a Washington Post column that she did so in part because, "I am a single mother who can't afford health insurance under Obamacare."

A friend of mine reported that while volunteering for the Clinton campaign in Pennsylvania, she encountered one voter who had just gotten off the phone with her health insurance company, "battling an astronomical increase in premiums. A cancer survivor, she had lost her favorite doctor when she went onto Obamacare two years earlier. Now her rates were going up." That voter wound up supporting Trump, too.

A Politico postmortem of the Clinton campaign reported, "The soaring Obamacare premiums announced last month hurt Clinton, some said."

Even Senator Elizabeth Warren, Democrat of Massachusetts, conceded in a post-election article: "Americans want reform to Obamacare—?Democrats included. We must bring down the costs of health insurance and the cost of health care."

What was Obamacare, in the end, but an arrogant overreach by an elite out of touch with the rest of America?

If that seems like an exaggeration, look at the election data. In Cambridge, home to Harvard and MIT—Gruber Country—Clinton won won 89.2 percent of the vote. That's nearly Saddam Hussein level. It was the highest percentage of any town or city in the entire state, 28.4 percentage points ahead of Clinton's 60.8 percent of the vote statewide in Democrat-leaning Massachusetts. In New Haven—the Cambridge of Connecticut, home to Yale—Clinton drew 86 percent of the vote. The only place she did better in the entire Nutmeg State was Hartford, where she drew 90.2 percent. In Hanover, N.H., home to Dartmouth College, Clinton won 84.9 percent of the vote—by far her strongest showing in any town in that entire swing state. F

For a comparative baseline, Clinton drew 54.5 percent of the vote statewide in Connecticut, 47.6 percent statewide in New Hampshire, and about 48 percent nationwide.

Other than Ivy League college towns, areas that went overwhelmingly for Clinton include places like Manhattan (85.9 percent); San Francisco (85.3 percent), and Washington, D.C. (93 percent).

Trump mentioned Professor Gruber by name in the second presidential debate. When a reporter from the Boston Business Journal reached Professor Gruber for his reaction after the election, he pronounced himself "stunned" at Trump's victory but nonetheless characterized the Affordable Care Act as "one of the greatest social accomplishments of our lifetime."

If the "accomplishment" is that the American electorate is now blaming their high health care bills on Democratic politicians, rather than on doctors, drug companies, or insurance executives, it is indeed pretty great, though perhaps not exactly in the way Professor Gruber intended it to be.

It is, as well, however, a cautionary tale for Republicans who hope to repeal and replace the Affordable Care Act. If voters are going to start blaming politicians for their health insurance and medical bills, the anger in the next election could be directed at the Republicans who now hold control of the White House and both houses of Congress. If the Republicans hope to do better than President Obama, Clinton, and Professor Gruber, they may want to start from the premise that American voters aren't stupid.