Gruber: GOP Governors’ Refusal to Expand Medicaid ‘Almost Awesome In Its Evilness’, Blames ‘Racial Reasons’

by Jim Geraghty

Who’s up for another Jonathan Gruber video?

On April 9, 2014, Gruber appeared on the  “Curbside Consult” interview series with Harold Pollack, at healthinsurance.org;  the host introduced Gruber as the “architect of Obamacare”, and Gruber made no objection.

Pollack says, “One of the things that’s really striking to me is there’s a politics of impunity towards poor people, particularly non-white poor people that is almost a feature rather than a bug in the internal politics in some of these states, not to cover people under Medicaid, even if it’s financially very advantageous to do so.”

Gruber’s response:

That’s a great way to put it. 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.

Ironically, later in the conversation, Gruber admits that the costs of Medicaid expansion are increasing as the number of patients on Medicaid grows rapidly:

Pollack: Medicaid is effectively becoming the 900-pound gorilla in the health insurance market in Kentucky. Something like one-third of the non-elderly population is going to be covered by Medicaid or related programs. How do you think that’s going to change the nature of Medicaid as it takes on such a large swath of the population?

Gruber: I think that’s a great question and I think the big issue is going to be: Can Medicaid continue to pay its doctors so poorly as it’s covering a larger and larger share of the population. Part of the reason Medicaid is cheap is because it pays doctors so poorly. Can that continue when it’s covering a third of the population? I’m not entirely sure that’s possible.

Later in the conversation, Gruber attributes the desire to cut Medicaid spending to racism:

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.

Your tax dollars at work, America.

The Campaign Spot

Election-driven news and views . . . by Jim Geraghty.