An expert in the field discussed the impact and the future of the health care law Patient Protection and Affordable Care Act, also known as the Affordable Care Act, at the March Mosbacher Institute’s Conversations in Public Policy Series event.
Jonathan Holmes Gruber, Massachusetts Institute of Technology economics professor and Technical Consultant to the Obama Administration on the Affordable Care Act, led the discussion. The lecture, hosted by the Mosbacher Institute and the Texas A&M Department of Economics on March 20, was followed by a Q&A which was moderated by Laura Dague, Texas A&M public service and administration associate professor.
Gruber said while issues remain in the United States healthcare system since the passage of the Affordable Care Act, the overall effect of the law has been positive.
“The two major goals of the [Affordable Care Act] were to increase insurance coverage and fix a broken insurance pool,” Gruber said. “On the former, it’s a complete success. Twenty million Americans gained insurance coverage. That is the consensus view for the [Affordable Care Act]. What about insurance markets? Well, this is where it is a little bit more controversial.”
During Gruber’s lecture, the health economics researcher described several effects of the law that were outside the original intent of the law, detailing how American society has been affected by the Affordable Care Act. For example, the overall spending on healthcare slowed in the years following the law’s passage.
Gruber is heavily involved in healthcare research and crafting public health policy. He is a research associate, the director of the Health Care Program at the National Bureau of Economic Research and an associate editor at the Journal of Public Economics and the Journal of Health Economics. As stated in economics associate professor Jason Lindo’s introduction, Gruber has also been described in the popular press as a key architect of both the Massachusetts health care reform, and the Affordable Care Act.
“I will probably never work on anything more fulfilling than my work on RomneyCare in Massachusetts and later on, working on Obamacare,” Gruber said.
The Affordable Care Act is a set of three mutually supporting interlinked ideas, according to Gruber. He said those are guaranteed coverage regardless of medical history, the individual mandate and subsidies for low income families — ideas originally proposed by the conservative think tank “The Heritage Foundation” and passed by former Massachusetts governor, Mitt Romney.
“It’s a three-legged stool,” Gruber said. “Obama, to his credit, said, ‘I will take this Republican plan and I will try and make it the centerpiece of my health insurance proposal.’ And that’s what Obamacare was. Obamacare is essentially that same Massachusetts plan with a face and a few more zeros.”
Health economics and healthcare policy has not historically been communicated to the public well, according to Dague.
“I think that sometimes the political reality of something is different from the expert consensus,” Dague said. “And that is because of a difference in public perception versus what the research says. That is something that can be fixed maybe through better communication of what is the theoretical consensus, what is the empirical consensus.”
In terms of connecting health economics to public policy, Dague said studying healthcare impact gives a better perspective on the optimal solutions available.
“It’s a shame that health policy in general has become so politicized,” Dague said. “Because many observers, many policy researchers, don’t think that many of these [solutions] are controversial.”