Obamacare Architect Jonathan Gruber Says, On a Second Occasion, that States That Do Not Set Up Exchanges Lose Access to Obamacare Subsidies

Last night,
a video surfaced
showing Massachusetts Institute of Technology
economist Jonathan Gruber saying in 2012 that if states do not set
up their own exchanges under Obamacare, they lose access to the
law.

The clip was important because Gruber is an influential health
policy analyst who helped author the law, and because his statement
matched both the plain language of the law, which says subsidies
are only available state-established exchanges, and the argument
made by legal challengers who have argued in court that the Obama
administration’s implementation of the law—which allowed subsidies
in federally run exchanges—is illegal. The timing was also notable.
Gruber made the statement before the paper laying out the legal
case against the administration’s implementation had been
published, and before the legal challenge against it had been
filed. 

Gruber has over the past year and a half repeatedly taken the
other side of the argument, saying on MSNBC this week, “It is
unambiguous this is a typo. Literally every single person
involved in the crafting of this law has said that it’s a
typo, that they had no intention of excluding the federal
states.”

This morning, in response to the clip, Gruber
told
The New Republic that the comment was a mistake.
“I honestly don’t remember why I said that. I was speaking
off-the-cuff. It was just a mistake,” he said.

He continued: “There was never any intention to literally
withhold money, to withhold tax credits, from the states that
didn’t take that step” [of creating their own
exchanges]. That’s clear in the intent of the law and if
you talk to anybody who worked on the law. My subsequent statement
was just a speak-o—you know, like a typo.”

But as it turns out, earlier in the month, he made the exact
same point, using similar language, once again calling the
possibility that states won’t set up their own exchanges a “threat”
to the law, and saying that residents in states that don’t set up
their own exchanges would not have access to tax credits.

“The third risk, and the one folks aren’t talking about, which
may most important of all, is the role of the states. Through a
political compromise, it was decided that states should play a
critical role in running these health insurance exchanges. And
health insurance exchanges are the centerpiece of this reform,
because they are the place that individuals can go to shop for
their new, securely priced health insurance. But if they are not
set up in a way which is transparent, and which is convenient for
shoppers, and which allow people to take their tax credits and use
them effectively by health insurance, it will undercut the whole
purpose of the bill. Now a number of states have expressed no
interest in doing so.

A number of states—like California, has been a real leader—one
of, I think it was the first state to pass an exchange bill. It’s
been a leader in setting up its exchange. It’s a great example. But
California is rare. Only about 10 states have really moved forward
aggressively on setting up their exchanges. A number of states have
even turned down millions of dollars in federal government grants
as a statement of some sort—they don’t support health care
reform.

Now, I guess I’m enough of a believer in democracy to think that
when the voters in states see that by not setting up an exchange
the politicians of a state are costing state residents hundreds and
millions and billions of dollars, that they’ll eventually throw the
guys out. But I don’t know that for sure. And that is
really the ultimate threat, is, will people understand that, gee,
if your governor doesn’t set up an exchange, you’re losing hundreds
of millions of dollars of tax credits to be delivered to your
citizens.”
[emphasis added]

If this is another mistake, it is an awfully strange one that
just happens to match—not only with the statement he made a week
later, but also with the plain language of the health law and
the argument advanced by legal challengers to the IRS rule allowing
subsidies within Obamacare’s federal exchanges.

Listen to the complete clip, via John Sexton at Breitbart:

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