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This Gruber Dude

Who is Jonathan Gruber and why should you care?

Dr. Gruber is an MIT healthcare economist who served as a consultant for the ACA (aka Obama Care). He has a very impressive background that includes more than one Ivy League school and he also worked on the healthcare plan in Massachusetts. I think he is a democrat and he openly supports the ACA.

If you know anything at all about Gruber, it is probably that he called you stupid. Technically, he called me stupid, too but I didn’t take offense. He was speaking of the American Voter in an accent heavily laced with sarcasm. These insults were leveed during talks and lectures over the past couple of years and were dug up by some poor individual who was searching for a reason underlying the increase in his family’s insurance premiums. That’s important. Gruber did not stage a press conference to call us stupid.

Are we clear? He is an economist, likely a democrat and supports the ACA. He is fluent in sarcasm and clearly not a politician. He tells the truth as he knows it and economists generally find their truth in numbers.

What Gruber has said could completely unravel the ACA.

When speaking of a tax on high dollar insurance plans, he said, ““The only way we could take it on was first by mislabeling it, calling it a tax on insurance plans rather than a tax on people when we all know it’s really a tax on people who hold those insurance plans.”

On passing the healthcare legislature: “…lack of transparency is a huge political advantage. … Call it the stupidity of the American voter or whatever, but basically that was really, really critical to getting the thing to pass.”

These two quotations are inflammatory to the point of being entertaining. They make good headlines and gossip and tell a story. More important but less entertaining is what Gruber said about individual states that don’t implement an exchange.

“If you’re a state and you don¹t 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.”

This is the heart of the case going to the Supreme Court. The law suit headed towards the highest court in the land is all about the tax credit offered to the individual states. The law reads that states that do not set up the exchange will not be entitled to tax credits which would affect 37 states. Proponents of the ACA state the language was obviously a typo and that’s not what the law really meant. Jonathan Gruber offered information to the contrary long before the case going to the Supreme Court was a reality.

If the Supreme Court rules that the law means what it says and they have a history of doing so, the only solution would be to change the law. As of November, half of the politicians who voted for the ACA are no longer in place. Oops.

I’m not sure that the citizens of 37 states want to pay for the healthcare of the citizens in other states while their own healthcare expenses increase.

Here’s where it gets really interesting. If the Supremes agree that the law means what it says and congress is not able to come up with a quick fix, how does that affect us?

The Face to Face documentation is a part of the ACA and if the law gets knocked down, were denials for the F2F unconstitutional as well? How about those restrictions on who can own a hospital? Is the hospital re-admission program part of the ACA?

What about all the people in the states who have no exchange? Will providers be paid? Will the insured get taxed?

The Supreme Court never implements anything. Rather, they determine if a law fits neatly into the constitution. If it doesn’t, it really isn’t their problem.

Tomorrow, Dr. Gruber is going before the senate for a grilling hearing. I will be watching and I hope you do, too, as you are able. We’ll be able to hear a little bit of the arguments we can expect to be brought to the Supreme Court. When they rule – probably next July, things could get very interesting.

Just so you know, and all….. I am much more inclined to trust a man with no filter than a politician trying to sell me something too complicated to understand.

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