In response to Obamacare Architect Jonathan Gruber Once Again Ties Subsidies to State-Based Exchanges:
These are terrific finds, but Gruber wasn’t the only one saying this stuff, and he’s not the only reason ObamaCare critics have long maintained that the federal exchange is not empowered to dole out the New Dole – the health insurance subsidies every member of what we used to call “the middle class” is now dependent upon. Senator Max Baucus said as much too, but it’s even bigger than him.
Quite a few members of the ObamaCare brain trust thought it was a good idea to offer subsidies as a reward for states that set up exchanges (or, to be less charitable, withhold them as punishment from states that refused.) There was also a point when ObamaCare was supposed to require states to set up those exchanges, but the idea was dumped because it was feared state governments would rebel. Imagine the level of resistance to this boondoggle in 2010 if the 36 states that declined to create exchanges had been marched into the system at gunpoint. Instead, they were given a phantasmal option to decline, which was to be brutally yanked away from them once the system went live, and the people in refusenik states noticed that their comrades in compliant states were getting big tax subsidies to defray the high cost of ObamaCare insurance.
This was supposed to be a trap that snapped shut in 2014. My guess is that some of the boobs who crafted the Affordable Care Act forgot that other boobs had left the state exchange trap in place, after concluding it would not be necessary. There was a lot of fractional wrangling and back-room dealing involved in the passage of the Affordable Care Act, which was one of the most shameful episodes in the history of the United States. (Remember such gems of pure corruption as the Cornhusker Kickback?)
Also, as you can see from the Baucus video linked above, a good deal of ObamaCare’s groundwork was laid parallel to state Medicaid programs. The scam artists who wrote the Affordable Care Act wanted to turn the whole thing into a gigantic set of unfunded mandates, dumping fiscal responsibility onto state governments while keeping ultimate power in Washington. When the whole thing ended up costing far more than promised in those ludicrous early projections, fingers of blame would be pointed at the states. One of the big reasons HealthCareDotGov was such an unmitigated disaster is that some of ObamaCare’s bureaucratic midwives didn’t seriously think they would be expected to create a system that could handle 36 states. (Those who paid careful attention to the wording of the Affordable Care Act would have noticed it made no provisions for a federal exchange system at all.)
We should keep in mind that ObamaCare was designed to fail. This whole thing was supposed to collapse in a few years and pave the way for single-payer socialized medicine. That little bait-and-switch would be much easier to pull off if the imploding ObamaCare system looked like fifty separate state failures (or, more likely, a number of states failing catastrophically while others more-or-less made ObamaCare work.) It’s a tougher sell if the public sees a massive federal program falling to pieces… which is exactly what has been happening, years ahead of schedule.
So yes, there’s every reason to think that many of the cooks stirring the sloppy ObamaCare pot intended the subsidy mechanism to work for states only, and never really intended a federal exchange at all. Some of them were hoping to create a federal system that would run parallel to the corporatist pseudo-private ObamaCare network in the fifty state exchanges – the “public option” of yore. Such a system would grind private insurance into dust over the coming decade, leaving only a public system that could be easily transitioned to single-payer socialized medicine. It’s not surprise to learn these factions were not on the same page, and the power-hungry politicians who signed their stupid bill into law had no idea what they were signing.