Health law architect’s ‘stupidity’ comments stir controversy

MIT economist Jonathan Gruber.Bill Greene/Globe Staff/File 2012/Boston Globe

MIT economist Jonathan Gruber has gotten into hot water again over comments captured on video, in which he refers to the “stupidity of the American voter” and “lack of transparency” in the drafting of the federal health care overhaul.

Gruber, often described as an architect of both Obamacare and the Massachusetts health care law, was speaking at an academic conference a year ago at the University of Pennsylvania. He said the bill was “written in a tortured way” to make sure that the Congressional Budget Office did not consider the mandate to buy insurance a tax.

He also said that the law’s requirements to prevent the exclusion of sick people from health insurance would never have passed if they had been made more explicit: “In terms of risk-rated subsidies, in a law that said healthy people are gonna pay in — if it made explicit that healthy people are gonna pay in, sick people get money, it would not have passed. ...Lack of transparency is a huge political advantge. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get anything to pass.”

Gruber, who also serves on the board of the Massachusetts Health Connector, caused a similar hubbub in July when a video surfaced in which he seemed to support the arguments against allowing subsidies in the federal health insurance exchange. A case before the US Supreme Court asserts that only people who buy insurance through state-based exchanges can get federal subsidies to lower their premiums; if this argument prevails, it could up-end a central provision of the Affordable Care Act.

The latest video was posted earlier this week on the Daily Caller, a conservative news website, and was quickly circulated among right-wing commentators, who cited it as evidence that Obamacare was, as one put it, “built on a foundation of lies.”

By mid-week, the Washington Post reported that a Congressional Republican had called for hearings, while writers at other media outlets rose to Gruber’s defense.

Gruber told the Globe earlier this week that he was speaking “off the cuff” at an academic conference but declined to comment further. Later, he apologized in an interview on MSNBC.

Philip Klein, commentary editor at the Washington Examiner, wrote that “Gruber’s comments get to the heart of what’s wrong with liberalism. At the end of the day, liberals not only believe that they’re smarter than the public, but that they have a better sense of what’s good for the people than Americans themselves.”

But Neil Irwin, writing in the Upshot blog in the New York Times, said Gruber was merely being honest about the way the legislative sausage is made in Congress. “Mr. Gruber was exposing something sordid yet completely commonplace about how Congress makes policy of all types: Legislators frequently game policy to fit the sometimes arbitrary conventions by which the Congressional Budget Office evaluates laws and the public debates them.”

And in New York magazine, Jonathan Chait provided a detailed parsing of Gruber’s words, concluding: “He was trying to explain how the law’s architects had to compromise the simple technocratic purity they might use to design the law in an academic setting to account for an irrational political system in which tiny bits of fact can be decontextualized and manipulated by demagogues.”