I don’t have a lot to add to the bizarre GruberGate controversy, which is basically an internal discussion among Republicans about whether to use old video of an MIT economist to lather themselves up into another assault on Obamacare that would probably end once it became obvious another government shutdown was the only real weapon they had. It’s bad news for those who hoped Republicans were adjusting to Obamacare’s abiding presence, or would react rationally if the Supreme Court pushes the Affordable Care Act into a highly technical and easily negotiated ditch. But it probably won’t matter in the long run.
It is, however, a reminder that complex public policy initiatives create all sort of political hazards. The Affordable Care Act, with its hybrid public/private structure, is inherently complex on a more basic level than what one chooses to call this or that financing element. That was one of the prices its designers paid for passing up on the more controversial but infinitely easier to understand single-payer model.
It didn’t help, of course, that the ACA was subjected to many tens (and by now hundreds) of billions of dollars of negative propaganda about “death panels” and Medicare and socialized medicine, most of it more or less made up (which makes its purveyors’ complaints about pro-ACA “lies” this week especially rich). But the “managed competition” approach to health care reform has always been complicated to explain, and its the critics, not the proponents, who have most benefited from that reality.