Jonathan Gruber strikes again. NRO's Jim Geragthy digs up yet another video of the increasingly infamous MIT economist sounding off on the law he helped design, and assassinating the character of its critics. In this episode, recorded in April 2014, Gruber rips into Republican opponents of Medicaid expansion, calling some governors' and legislators' efforts to reject the federal strings "almost awesome in its evilness." Note how the interview subject grins as he's introduced as "the architect" of Obamacare -- a reality some people are rather eager to deny these days:
"There’s larger principles at stake here. When these states are turning – not just turning down covering the poor people – but turning down the federal stimulus that would come with that. So the price they are willing … They are not just not interested in covering poor people, they are willing to sacrifice billions of dollars of injections into their economy in order to punish poor people. It really is just almost awesome in its evilness."
Here's a guy who has proudly boasted on camera of repeatedly misleading the "stupid" American people in order to achieve his ideological ends -- which also just so happened to personally enrich him to the tune of millions of dollars -- calling other people "evil" and spiteful for disagreeing with his grand project. In addition to "punishing poor people" (more on that in a moment), Gruber later follows his party's all-purpose script by playing the race card:
"I really believe that if we could politically help explain the costs to society of cutting provider rates, of cutting back Medicaid, I think we’d get the majority of people to support strengthening that program. I think it’s just because of racial reasons and other things, we just haven’t managed to get through with that message."
Remember, in its original form, Medicaid expansion at the state level was mandatory. After that provision was struck down as unconstitutional by the Supreme Court on a 7-2 vote, a number of Republican-led states have declined to take the federal government up on its "generous" offer. The feds' supposed largesse comes with strings attached, as phased-in pay-fors require the states to start picking up a portion of the higher tab in future years. Beyond that objection, many conservatives' opposition to expanding Medicaid is that the existing program is already a mind-blowingly expensive failure. Last year, a gold-plated, comprehensive study on Oregon's Medicaid program (widely considered to be one of the the best in the country) dropped like a policy bomb on healthcare wonks. It concluded that low-income Oregonians enrolled in Medicaid do not experience any measurably better health outcomes than their uninsured counterparts. In short, gobs of taxpayer money has been, and is being, spent on a program whose 'beneficiaries' are faring just as badly as people without any coverage at all. Medicaid data out of Oregon also showed that despite Medicaid expanders' rationale
Medicaid also represents the pinnacle of the healthcare adage that 'coverage does not equal care.' Even prior to its sweeping expansion under Obamacare, huge numbers of the program's enrollees were already suffering from access shock, unable to find doctors who accept Medicaid patients, due to prohibitively low government reimbursement rates. A lasting, well-publicized issue. Obamacare (very much including its Medicaid elements) has significantly worsened this problem. Many conservatives, therefore, look at the optional Medicaid expansion and see an already-failing, strained program fraught with federal strings and obligations. They conclude that doubling down on that program by flooding it with millions of additional Americans would be madness, and would actually harm Medicaid's truly indigent pre-Obamacare recipients by applying even more pressure to a rickety, dysfunctional system. (Might this qualify as "punishing the poor"?) Yet the man whose own study exposed Medicaid's fatal flaws to the world has denounced these judgments as borne out of evil bigotry and vindictiveness, rather than an entirely rational response to the available data -- including important data supplied by himself. I'll leave you with a 'Grubergate' highlight reel from American Commitment, and also be sure to watch
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