Tag: Obamacare

Sunday Triple Play

Three thoughts on unrelated topics:

Brexit:

When it came to the Brexit vote, I was partial to Remain, mainly because I am an avid supporter of free trade. And I’m worried that the departure of the UK could trigger an eventual dissolution of the EU, with bad economic consequences and an empowerment of Russia. I still worry about this but … I think the reaction of the Remain faction has been hysterical. Vox alone has run a few dozen articles rending their garments and gnashing their teeth over this. To borrow a thought from Greg Guttfield, this is about ten times as many articles as they’ve run on Venezuela, which is having an actual economic meltdown right now, with severe shortages of good, medicine and power. For Americans to go into hysterics because the UK’s economy might be a little weaker going forward while ignoring the Lord of the Flies situation developing in our own hemisphere is insane. McArdle argues they are lamenting the decline of this idea that we will no longer be citizens of nations but “citizens of the world” — a notion that has a lot of sway in elite circles.

Warren Meyer has a great post up, contrasting the “it was racism!” explanation that is now the default on the Left against the real regulations coming down on things like tea kettles. It’s worth a read but here’s a critical point:

The real crime from a US perspective is the actions of our President. Mr. Obama has told the British that by voting for Brexit, they go to “the back of the line” for trade negotiations with the US. This is, amongst a lot of stupid things politicians say, one of the stupidest I have ever heard. My response as president would have been to move Britain to the front of the line, offering them a free trade treaty with the US the day after the Brexit vote. Like most politicians, unfortunately, President Obama does not view trade as a vehicle for the enrichment of individuals but as a cudgel to enforce his whims in the foreign policy arena. Why on Earth has President Obama threatened to undermine America’s strong interest in trading with the UK merely to punish the UK for not staying in the EU, a transnational body this country would certainly never join?

The UK would be one of the most logical countries in the world for us to have a free trade agreement with. I have little hope that our next President will grok this.

Orlando:

The FBI has said that they have no evidence that the Orlando shooter was gay. That doesn’t prove he wasn’t, as the FBI notes. There are still indications from his friends and wife that he might have been. But the narrative that he was actively dating men and a regular at the club appears very unlikely.

The FBI is currently saying “they may never know” his motive, given some of the ambiguity around his sexuality. But given that he called 911 to specifically pledge allegiance to ISIS and Abu Bakr al-Baghdadi, the slightest thought might begin to speculate about the merest possibility of crossing our minds that this was Jihadist terrorism. Especially as Jihadism and killing gay people are not exactly incompatible ideas.

Honestly, theres enough blood to go around. We don’t have to confine ourself to one motive.

Obamacare:

Blue Cross has announced that they are pulling out of the Minnesota individual insurance market. The Kaiser Foundation is projecting steep hikes in insurance premiums. The longer this goes on, the more Obamacare is faltering, slowly destroying the individual market. We’re barely two years into this thing and we are now at the point where it’s not if, but when, Obamacare is going to face a massive overhaul. I don’t know that the insurance market can be repaired after this. But I know that if we dick around for much longer, we’re going to see uninsured rates spike drastically to the point where individual insurance may cease to exist.

Makes you kind of wonder if that was the point.

Pelosi Watch: Highmark Jumps

Remember when Nancy Pelosi said we had to pass the healthcare bill to find out what was in it? Well, we’re finding out ever more:

Citing an estimated $500 million loss last year on health insurance plans sold on the Affordable Care Act marketplace, Highmark Inc. said Friday it plans to reduce what it pays doctors who treat patients with the plans.

Highmark plans to reduce payments to the physicians by 4.5 percent starting April 1 as part of a broad effort to stem losses related to the federal marketplace, said Alexis Miller, Highmark’s special vice president of individual and small group markets.

Miller estimated the insurer paid about $500 million more for patients’ care in 2015 than it collected in premiums for the plans sold on the federal marketplace, resulting in the loss. Highmark officials have said the people who signed up through the health law’s marketplace were sicker than the insurer expected.

This is precisely what was feared. Guaranteed issue would mean lots of sick people would sign up for insurance, costs would soar and insurance companies would either have to raise rates (triggering a possible death spiral) or cut what they pay doctors (driving some out of the system).

Keep something else in mind: Bernie’s Sanders absurdly optimistic single payer plan depends on cuts to reimbursement that are at least four times what Highmark is considering.

Pelosi Watch: Poor Hospitals

Nancy Pelosi once said we had to pass Obamacare to find out what was in it. And boy are we finding out:

An Obamacare program that aims to improve American health care may have an unintended side effect: penalizing hospitals that serve the sickest and poorest patients.

The Affordable Care Act penalizes hospitals that have high readmission rates, where patients come back within 30 days to deal with some complication of the initial procedure. The aim of that program was to encourage doctors to do the best job possible on the first hospital visit, improving patients’ experience and saving money by preventing a second trip.

But a new paper from three Harvard health-care experts suggests that the readmission program is penalizing hospitals for the type of patients they see. Hospitals that have high readmission rates tend to see patients who are less educated, more disabled, and more likely to suffer from depression — factors the Obamacare program doesn’t account for.

I suspect that you, like me, are shocked SHOCKED that a bill designed by politicians and wonks to exert control over a massive and complicated system didn’t work precisely as advertised. Keep in mind … this is one of Obamacare’s supposed big successes. They’ve touted the “huge” drop in readmissions (all of … 1%) as a sign of how awesome their reform is.

To be fair, penalizing hospitals for readmissions is not a completely stupid idea. Several insurance companies have been trying out programs to encourage better care. But the Obama people didn’t care for this kind of free-market innovation. To them, providers were greedy monsters doing poor care so they could charge more (remember Obama’s comment about amputating diabetic legs?) So they applied a ham-fisted program that has, on balance, made things work.

Well … at least we’ve seen insurance rates come down, right? Right?

Oh, yeah.

The Culture War Rout Is On

So, this week George Takei called Clarence Thomas a “clown in black face” for this dissent in Obergefell. He has since apologized for the remark, claiming that he said it in a moment of anger.

As you know, I’m not one for the Outrage of the Day. What set Takei off was Thomas’ argument that government can not take away your dignity no matter what it does; dignity is intrinsic. Thomas used the internment camps as an example and Takei, who was interred, was angered by that comparison. That’s understandable.

However …

The reaction to Takei’s remarks has little to do with him. It has everything to do with a racial smear campaign that has pursued Clarence Thomas since the day he joined the Court. Just as Takei’s comments have their origin in his long experience with racial and anti-gay discrimination, the backlash to them has its origin in 24 years of liberals slagging Clarence Thomas, all too often in racist language. Thomas is a race traitor. Thomas is an Uncle Tom. Thomas doesn’t know his history. Thomas is an idiotic sock puppet of Scalia (actually, the Scalia-Thomas pairing isn’t even in the top ten for SCOTUS). Thomas never writes any significant opinions (I recently cited his wonderful dissent in Kelo; he’s written many many others).

We’re told that Thomas doesn’t understand or care about race relations. We’re told this of a man who was born in the segregationist South; who experienced vile racism in his early life; who was and is an admirer of Malcolm X; who is thoroughly versed in our country’s racial history; who can cite you chapter and verse about how our country has perverted the law and the Constitution to screw over black people. Thomas is well aware of his race, conscious of it and proud of it. But he the temerity to disagree with liberals about how the Constitution should be applied to the law. And so none of that matters.

But there’s something here even beyond the usual Clarence Thomas race-baiting. Let’s take a step back. For the last week, numerous Republicans have been responding angrily to the gay marriage and Obamacare decisions. Rick Santorum, Mike Huckabee and Bobby Jindal, among others, have questioned the Court’s legitimacy. We’re told that this is a sign of how insane Republicans are. But … you’ll see equal amounts of rage from the Left when the Court doesn’t go there way. Hell, just last week, people were responding to Scalia’s dissent with angry tweets and articles about Bush v. Gore and Citizens United, decisions which liberals responded to by … gasp! … questioning the legitimacy of the Court.

Look, it’s understandable that people get mad at the Court when it makes decisions they don’t like. Hell, I’m still upset about Kelo. That’s fine. I really don’t see anything unusual or alarming about anti-gay-marriage politicians being angry about the recent decisions. We have to accept the Court’s decisions as a matter of law; but that does not mean we have to accept them into our hearts. Be angry when you think the Court has gotten it wrong.

What’s striking, however, is how angry the Left gets when they win. Granted, most of the Left is just plain happy about last week’s decisions. But there’s a not insignificant faction that’s just furious that the conservative bench had the nerve to dissent.

As Clark at Popehat recently noted, the Culture War in this country has had two distinguishing features: an incredible series of wins for the Left and an even more incredible series of whinges about it:

The problem I have is that the blue alliance has been on a winning streak, and with recent Blue success in gay marriage, immigration of client populations, university-and-media roll-up, etc. I feel like the culture war is over and the victors are going around (metaphorically) humiliating and shooting survivors of the losing side, and conducting mop-up operations. Witness team Blue forcing bakers to bake cakes and forcing photographers to shoot photos for partnerships that they consider immoral. Witness blue team arguing that innocent people should go to jail for rape, because – and I’m quoting Ezra Klein here – we “need to create a world where men are afraid.” Red team men, I take that to mean. Football players. Frat boys. Not nice guys like Ezra.

Look at how the reasonable Left, who would never question the legitimacy of the Court, responded to last year’s Hobby Lobby decision. Just to remind you: the Supreme Court decided that the government could force almost all employers to provide unrestricted contraception coverage to their employees. But because of the RFRA, they decided that a small subset of businesses — privately owned or closely held businesses — could refuse coverage for a small subset of birth control methods that they considered abortificients. It’s exactly the kind of compromise that the Left always claims to want; one that respects our diverse and pluralistic country. In fact, it’s better: they got about 99.5% of what they wanted, with a small bone thrown to religious conservatives. Even better, the Court’s decisions was grounded in a law that can be repealed, not in any supposed First Amendment rights of corporations. By any definition, it was a big win for them.

And yet .. the “reasonable left” who would never question the legitimacy of the Court, responded by proclaiming that we were in a corporate theocracy. They disparaged Catholics on the Court. We were told that it turned back the clock on women’s rights. You can see a bunch of “reasonable” tweets here, including a comparison to Plessy vs. Ferguson (remember when Republicans comparing SCOTUS decisions to Dred Scott was over the line? Good times.)

That’s when they “lose” by such a tiny amount it’s really a huge victory. But last week, the Left won outright. And granted, most liberals are responding with jubilation. My FB feed filled with happy posts about the victory of gay rights. But there is a noisy faction that have spent the last week poring through the dissenting opinions to find something, anything to get in a tizzy over. Jon Stewart has done multiple segments mocking the dissenting opinions and the politicians who didn’t like the rulings. And then, of course, you had Monday’s afterbirth when liberals screamed that the Court has “struck down” limits on mercury emissions (it did nothing of the kind).

So, on it’s own, Takei’s remarks are nothing — something dumb said out of anger. But in the larger context, it was the intersection of two ugly trends: racial animosity toward Clarence Thomas and incessant left-wing whinging about a political battle they have won.

So, yeah, Takei’s apology is fine (Thomas, I suspect, does not care either way). But it’s nothing compared to the long smear campaign against Clarence Thomas and the vitriol with which far too much of the Left has responded to a decision that went their way.

The Culture War is over, guys. You’ve won. Hell, I’m on your side for most of these social issues. We’ve won. Do you really have to ride down your defeated foe?

King Denied

The Supreme Court has just ruled 6-3 that the Obamacare subsidies apply to states that do not run their own exchanges, thus upholding a major provision of the law. I’ll post more when I have time. Discuss.

One thing I’ll note: I was not surprised. The Roberts Court really hates to overturn legislation. They prefer to let legislators do that. The theme from Roberts in the two Obamacare decisions is basically this: if you want to repeal, repeal the law. We’re not going to do it for you.

Update: The more I think about it, the more I think the Court reached the right decision here, much as it pains me to say so. I don’t think King’s case was “ridiculous” as many liberal pundits opined. It’s never ridiculous to argue that a law should be interpreted as it was written. But I do think it was the language was ambiguous enough and the intent of Congress during the debates plain enough for the Court to defer to them. The message from the Court, as I noted above is “we’re not going to repeal Obamacare for you”.

(And I think the GOP is secretly grateful. As Thrill pointed on Twitter, this decisions basically saved them from having to repair the law.)

The way forward is pretty clear: replacing Obamacare becomes the key GOP electoral issue in 2016. The law, as Justice Roberts noted in his majority opinion, is still a mess. While the number of insured has been reduced, there has been no improvement in overall health. It’s saving some people from crippling financial bills but at enormous cost. And we are still in very real danger of an insurance “death spiral” that will destroy the individual market.

The shape of that replacement is up in the air right now. I prefer a bill that eases the link between insurance and employment, allows insurance to be sold across state lines and encourages the kind of high-deductible insurance that has been shown to reduce healthcare costs with little impact on overall health. But we’ll see what happens. The Court has put the ball into the GOP’s court. Let’s hope they don’t step on it and fall on their ass.

Update: You should read Scalia’s blistering dissent. It’s vintage Scalia, complete with saying the law should now be called “SCOTUScare”. It makes good points, I think, and shouldn’t be dismissed.

Update: Doug Mataconis explains the Court’s reasoning:

As Chief Justice Roberts noted, Courts have always been deferential when it comes to statutory interpretation in order to ensure that Judges are not substituting their judgment for elected representatives. The fact that there is a drafting error, or that language in a bill that was more than a thousand pages long is inexact in some way should not necessarily mean that a Court must interpret a law in a manner that brings down an entire statutory scheme. The alternative would be a world where the lack of a single word, or an in-artfully drafted sentence, would bring down an entire law, and that’s never been the way the Courts have interpreted statutes. In my past comments about this subsidy issue, I’ve been somewhat sympathetic to the argument of the Plaintiffs in this case, but reviewing the pleadings and the oral argument in this case have caused me to reconsider that position. I’m still not a fan of the PPACA, and I think that it’s going to create long-term economic incentives that will make health care more expensive rather than less expensive, but that is a policy matter not a legal one. As it stands, it seems clear to me that the Justices in the majority got it right.

Court Season

The Supreme Court is set to issue a number of landmark ruling this month (saving them for the end of the session, as usual). You can read Doug Mataconis or Evan Bernick for good conservative takes. I’ll do quick hits with how I think the Court will rule and how I think the should rule. And, of course, as each ruling comes down, I’ll put up a post.

The thing about the Roberts Court is that they are very conservative. Not in the political sense, but in the temperamental one. They prefer not to make broad sweeping decisions that upend masses of law and precedent. They tend to defer to legislatures. They like to rule narrowly and specifically. Roberts works very hard to build consensus (see last year’s slew of 9-0 decisions). They have been slow to defend civil liberties except for the First Amendment. So while I expect some landmark decisions, I don’t expect any that will radically reshape the law.

I do expect, however, to hear the losing side of several cases scream that the Court has exercised unprecedented power, set fire to the Constitution and brought plagues of locusts. Whichever side they oppose will be acting in a purely partisan fashion while their side are zealous defenders of the faith. You can decide if that hysteria is warranted.

Read more… »

Insurance is Not Healthcare

For a long time, conservatives and libertarians have been pointing out that Obamacare has come at a steep price for the insured. Not only are health insurance premiums rising, but the new plans cover less, demand healthcare within ever-shifting networks of approved providers and foist larger out-of-pocket expenses on patients.

Well, looks like the New York Times finally figured this out:

A study by the Commonwealth Fund this month found that the rise in health insurance premiums in employer-based plans had slowed in 31 states since the passage of the Affordable Care Act (good news, right?). But premiums were still rising faster than median incomes (hmm). More important, perhaps, the researchers found that patients were paying more in health care expenses than ever before, during a time of stagnant wages (not so great). In fact, nearly 10 percent of median household income now goes to pay premiums and deductibles, the study found. And that does not include other kinds of health payments that patients now encounter, such as co-pays and uncovered drugs or services.

A recent New York Times/CBS poll found that 46 percent of Americans said they had trouble affording health care, up 10 percentage points in just one year. Some of the cost problems may ease as patients — now known as health care consumers — learn what to expect and how to choose and navigate their plans.

In other words, premiums slowed down … but only because out-of-pocket expenses increased. On balance, that might not be such a bad thing. I’ve long advocated high-deductible plans as a way to bring the healthcare consumer back into the picture. David Goldhill once pointed out that if we replaced Medicaid with a high-deductible plan, we’d save enough money to give every poor person a voucher to cover their deductible.

But this isn’t the high-deductible idea. This is creating a hyper-regulated marketplace in which insurers are expected to provide “reasonably priced” health insurance to everyone, no matter how sick they may be. So doctors flit in and out of approved networks. Out-of-state clinics come to be preferred over in-state ones. And all of this is enforced with the threats of massive bills if you don’t do the insurance company’s bidding. And if you do their bidding, you’re still facing far larger healthcare bills than you were dealing with before Obamacare.

All of this was predictable of course. You simply can not expand health care coverage to ten million people — many of whom couldn’t get coverage because of expensive medical conditions — and not have it make insurance more expensive. We warned people about this for years. We had concrete examples of this in places like New York and Massachusetts. And yet everyone is acting all surprised when they discover that healthcare isn’t free.

Note one thing the story leaves out: the increasing number of doctors who are refusing to see Medicaid patients. Medicaid expansion is a big reason the Obama Administration can claim that they’ve insured ten million people. Only a couple of million have gotten private insurance thanks to Obamacare; most are in the Medicaid gulag.

Given the media’s lag, I expect we’ll start seeing stories about that in about 2019, at which point it will be blamed on President Walker.

Addendum: You may remember that a big pillar of Obamacare was that it would be paid for, in part by the savings from Electronic Healthcare Records. Yeah, that’s not working out either. Again, this was predicted. The one thing we all knew going into this was that EHRs are very expensive.

They’re Lying. Again.

Wow:

The Obama administration included as many as 400,000 dental plans in a number it reported for enrollments under the Affordable Care Act, an unpublicized detail that helped surpass a goal for 7 million sign-ups.

Without the dental plans, the federal government would have had 6.97 million people with medical insurance under the law known as Obamacare, investigators for the House Oversight and Government Reform committee calculated, using data they obtained from the U.S. Centers for Medicare and Medicaid Services.

Federal officials said in September they had 7.3 million people enrolled in coverage through new government-run insurance exchanges. They didn’t distinguish between medical and dental plans, breaking from previous practice without notice.

Blending dental and medical plans let the administration assert that enrollment remained greater than 7 million, the original projection of the Congressional Budget Office. The move also partly obscured the attrition of more than 1 million in the number of people enrolled in medical insurance.

The Administration is saying this was a mistake and the liberal bloggers are spinning, spinning spinning. The main talking point is that Obamcare basically met its goal (6.97 million vs. 7 million) and that, hey, lots of people are now insured. But saying that you met your goal (almost) is a huge political difference from saying you exceeded your goal, especially in … wait for it … the run up to an election.

They’re lying. They always lie. They’re just getting caught now.

The Gruber Chronicles

No doubt, you’ve heard a bit about the Jonathan Gruber videos emerging this week. Gruber came to light earlier this year for videos in which he argued that the supposed “scribal error” in Obamacare was intentional — i.e, that states that do not build exchanges shouldn’t get Obamacare subsidies. These new videos show him slagging the American voter, boasting about how they deceived the public on aspects of Obamacare and basically acting like an arrogant twerp.

There’s been a small wellspring of sympathy for him, since he’s now caught up in an unexpected controversy. Personally, I find it difficult to find a lot of sympathy for a man who was paid $400,000 to help deceitfully foist Obamacare on us, but whatever.

I don’t think Gruber’s comments, however angering they are, are going to make much difference. Obamacare passed and has survived at least one SCOTUS challenge. His comments on the subsidies are a good talking point on Halbig but SCOTUS is going to base their decision on Congressional intent, not the post-facto comments of some MIT windbag. No matter how involved he was in writing Obamacare, it is the intent of the legislators that matters.

But there is one aspect of the Gruber videos that is important. It proves that not only were critics of the law right, but that the Administration knew they were right and lied and obfuscated about the law. It’s not a “scandal” in the sense that anyone broke the law. But it’s a scandal in what it reveals about Obama, the Democrats and the so-called fact-checkers.

Take the CBO scoring. One of the big selling points of Obamacare, from day one, was that it would decrease the federal deficit. Critics pointed out that it only did this because of gimmicks — the taxes penalties fines taxes phased in a little faster than the subsidies. Critics pointed out that it depended on unlikely money-saving events, such as not enacting a “doc fix” (said doc fix having been promised to the AMA in return for their support of the bill). Critics pointed out that while it was technically balanced over the ten years, by year ten, Obamacare was running a deficit, a deficit that would only increase over the years. Critics also pointed out that CBO analysis, if you dug deep, made exactly these points. While they were required by law to score it the way they did, they noted, numerous times, the flaws in their projection.

When we pointed this out, we were called liars and tools of the insurance industry. Fact-checkers rated this claim as false. Of course, time has born out our complaints. But what the video shows is that the Administration was well aware of their deceit — how could they not be? This wasn’t a quirk; this was an act of deliberate deception. And they were laughing about it all the way back to their comfy positions in academia and industry.

Another big point is the so-called “cadillac tax”, which enacts a fee on healthcare plans that cost more than a certain amount (at least, for some people). When this plan was rolled out, critics pointed out that it was indexed to inflation, not healthcare costs. This would mean that, over time, more and more plans would qualify as “cadillac plans”. The result would be to effectively eliminate the tax deduction for health insurance.

Now one can make the case that the tax deduction is bad law. But that’s not the case the Obama Administration made because they knew eliminating the tax deduction for health insurance would be extremely unpopular and likely scuttle the entire bill. So they came up with a convoluted and tangled way of doing it. And when critics pointed this out, they were called liars and tools of the insurance industry (the insurance industry having written much of Obamacare).

Now that everyone is admitting to what Obamacare does, the President’s supporters are … blaming the stupidity of the voters for making these lies necessary. We’re being told this is standard operating procedure in Washington (it isn’t), that everyone does it (they don’t) and that the critics are being hypocrites (for … um, being right all along?)

We see this over and over again with this Administration. Here is my own attempt a one-act play that encapsulated the last six years:

Obama: My law does X.

Critics: The law also does Y and Z and it doesn’t do X very well.

Obama Supporters: Tea Partiers! Extremists! How dare you come here with your astroturf talking points!

“Fact Checkers”: Obama says the law does X. We rate your claim as false.

[Three years pass]

“Fact Checkers”: Actually, the law also does Y and Z and does’t do X very well.

Critics: We told you!

Obama Supporters: Shut up! Y and Z are great policies! Obama had to lie about it because you’re so fucking stupid!

The gripping hand here is that this will not make any difference. Most of the vast American public could give two shits about Jonathan Gruber. This will not have any impact on the Halbig case or any other legal challenges nor will it play a role in any attempts to fix or repeal Obamacare. It will persuade few to repeal the bill who don’t already want to. It’s mostly Washington insider stuff. I find myself agreeing with Tyler Cowen: let’s put all this energy into explaining why these policies are so bad rather than whether Gruber is an arrogant prick or the devil incarnate.

Gruber is nothing. Obamacare is everything. We can do something about the latter. And now we can use the Administrations own words to help make it happen.

Hoist By Their Own Petard

Let’s remember, for just a moment, how Obamacare was passed. It was cobbled together by a team of industry insiders to cater to all the special interests. It was then sent to Congress, where it would be honed and passed. But when Scott Brown won the election in Massachusetts, they suddenly did not have a filibuster-proof majority. So they rushed it through on a budget reconciliation. As a result, the bill contains a lot of bad language, poor wording and unclear statutes. Nancy Pelosi famously said we had to pass it find out what was in it. And now we’re finding out that what’s in it could destroy it.

Earlier this week, the DC Circuit Court ruled that the Obamacare subsidies could not be given to people whose states had not set up insurance exchanges because the law did not specify it. Liberals screamed blue murder about activist courts and people losing insurance and other arguments from the “Oh Come On!” school of jurisprudence. They said that Michael Cannon and Cato and other people arguing that the subsidies were meant to be withheld to force states to set up exchanges were “sociopaths” who would say anything to take insurance away from the poor. They’re livid that Obamacare might be overturned by what they’re calling “a typo”:

his week, Jonathan Gruber appeared on MSNBC to assert that the DC Circuit appellate court got the ObamaCare statute all wrong in its Halbig decision. Gruber, one of the key architects of the ACA and of the Massachusetts “RomneyCare” law that preceded it, insisted that the state exchange requirement for subsidy payment was purely accidental. “It is unambiguous this is a typo,” Gruber told Chris Matthews. “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.”

Even if that were true, these kind of typos are what you get when you shove a law through without reconciliation. And while “everyone” might agree that Congress intended the mandates to be universal, it’s difficult to tell what Congress intended because Congress barely debated the fucking thing.

But is it true that Congress intended the subsidies to be universal? For that, we should ask one of the architects of Obamacare such as … um … Jonathan Gruber?

Two years ago, though, Gruber gave a much different explanation for this part of the ObamaCare statute. Speaking at a January 2012 symposium for a tech organization that this was no typo. It was, Gruber said, a deliberate policy to twist the arms of reluctant states to set up their own exchanges — and that a failure to do so would mean no subsidies for their citizens.

You can go to Hot Air and watch the video, including the full video that shows this was not taken out of context. Gruber has since said his words were a “speak-o” and he was mistaken. If so, this Obamacare architect — who was paid a cool $400,000 for his contribution — now appears to have made that “speak-o” multiple times.

As Ed Morrissey points out, this doesn’t really matter for the court case. The Court will be considering Congressional intent not consultant intent. And to be perfectly frank, Gruber is a hack who will say whatever the Obama Administration wants him to say. If he got a memo saying that Obamacare was actually French Toast, he’d be handing out eggs and butter at these meetings.

But it does make for some great entertainment to watch these guys flounder around trying to explain what the bill really means.