As we've all watched Republicans quiver with delight over the comments of MIT economist Jonathan Gruber about the Affordable Care Act, I've wondered what they really think about this little controversy. By which I mean, do they believe that "Former adviser to White House says politically intemperate things" is just a handy bludgeon with which to beat Barack Obama about the head and shoulders, or do they really think that Gruber's words are some kind of magical key that, now found, will enable them to destroy the ACA?
I lean toward the former, mostly because their analysis of what exactly Gruber said has been so general (the law was sold on lies!). Though a lot of attention has been paid to Gruber referring to the "stupidity" of the voters, that's only of substantive concern if he was revealing some specific way in which the administration deceived the public. And when he said that, he was trying to say that the public didn't grasp that some people would be paying into the system but not using it, while others might be getting more than they paid for. Since that's what we call "insurance," there's no evidence that the law's advocates actually tried to conceal this bit of information or that things would have turned out differently had it been a more active part of the discussion.
But conservatives are still trying to put Gruber's comments at the heart of some vast deception from back in 2009. Take, for instance, this column from John Fund at the National Review:
This is serious. There have been flim-flam attempts to sell legislation in the past—the Left is now trying to distract attention from Gruber’s comments by citing passage of the Bush administration's Medicare prescription-drug benefit in 2003. But there are some key differences. Despite its many shortcomings, the Bush prescription-drug benefit wound up being that rare government program that wound up costing substantially less than the predictions that were made at the time of its passage. And it didn't involve the sweeping stranglehold on one-sixth of the nation's economy that Obamacare entailed.
Though he doesn't state so explicitly, Fund's implication is that back in 2009 Jonathan Gruber successfully deceived all America into believing that the Affordable Care Act would end up costing much less than it actually did, unlike Bush's Medicare prescription drug law. There's only one problem with this implied claim: the Affordable Care Act has actually not cost more than we thought it would in 2009. In fact, it has cost less. Let's look at the latest Congressional Budget Office estimate from earlier this year:
CBO and [the Joint Committee on Taxation] have updated their baseline estimates of the budgetary effects of the ACA's insurance coverage provisions many times since that legislation was enacted in March 2010. As time has passed, the period spanned by the estimates has changed. But a year-by-year comparison shows that CBO and JCT's estimates of the net budgetary impact of the ACA’s insurance coverage provisions have decreased, on balance, over the past four years (see the figure below). That net downward revision is attributable to many factors, including changes in law, revisions to CBO's economic projections, judicial decisions, administrative actions, new data, numerous improvements in CBO and JCT's modeling, and lower projected health care costs for both the federal government and the private sector.
And here's a picture:
Those are the coverage provisions, i.e. the stuff that costs a bunch of money; it doesn't include the taxes and cuts elsewhere that were included in the ACA. Those things are why the ACA serves to decrease the deficit, in part because, unlike the Medicare prescription drug benefit of which John Fund is so fond, it actually paid for itself (the cost of the drug benefit was just added to the deficit). The CBO has also estimated, in response to a request from John Boehner, that repealing the ACA would increase the deficit by over $100 billion over ten years. This gives Republicans no pause, because as we know, the deficit is only a concern that should constrain our choices when it comes to Democratic priorities like giving people health care or building infrastructure; when Republicans have something they want to do, like start a war that will cost a couple of trillion dollars, only wimps care about deficits.
But the point is, if Jonathan Gruber had successfully hoodwinked us all into thinking that the ACA would cost less than it ultimately did, and we were just finding that out now, conservatives might have a case for why his comments are so terribly important. But he didn't.
And let's be honest: the budgetary impact of the ACA (which, to repeat, has the net effect of lowering the deficit) is about the last objection conservatives have to it. They hate the law because it expands government regulation of the health care industry, because it gives millions of people insurance through Medicaid, and most of all, because Barack Obama did it, which as far as they're concerned is reason enough all by itself.