Gruber Involved in Creation of Colorado Health Exchange



State exchange supporters contracted with analyst

As originally published on November 16, 2014

by Joshua Sharf

The Colorado Health Institute paid Obamacare advocate and administration analyst Jonathan Gruber to produce an “independent” report in support of Colorado’s Health Insurance Exchange in 2011. This work came after the analyst’s failure to disclose his paid work to editors at newspapers which published his columns advocating for the law. CHI describes itself as a “nonpartisan health information resource for Colorado legislators.”

Gruber is currently under scrutiny for a series of video clips in which he 1) acknowledges having lied about the content of Obamacare in order to help get it passed, 2) refers to the “stupidity” and “economic illiteracy” of the American public as assets in passing the law, and 3) admits that the plaintiffs’ argument in pending litigation is correct—enrollees on the federal exchange were specifically and intentionally excluded from receiving subsidies.

Forgotten, however, is that in January 2010, Gruber was penning op-ed pieces in theWashington Post and New York Times advocating for Obamacare, without having disclosed to his editors that he received nearly $400,000 from the administration to produce an “objective analysis,” that would be used in promoting the legislation.

The discovery of this conflict of interest by the liberal blog FireDogLake eventually caused the Times’s Public Editor, Clark Hoyt, to admit that the source’s interest in the news ought to have been disclosed. As David Henderson at Econlog put it:

Jonathan argues, probably correctly, that he was not paid for writing the pieces. But I think he’s too good an economist not to know that you don’t have to be paid directly for there to be a conflict of interest.

In fact, as FireDogLake later pointed out, the contract was not for research, but for consulting.  In effect, the White House paid Gruber for ideas to be incorporated into Obamacare, and then cited his research as independent, objective analysis supporting the fiscal and economic soundness of their proposals, when it was anything but.

The same thing may have happened here in Colorado, roughly two years later.

Over a year after this controversy erupted, the Colorado Health Initiative, a private non-profit dedicated to “serving as an independent and impartial source of reliable and relevant health-related information for sound decision making,” issued a Request For Proposal (RFP) COHIEX #0001 for a study to analyze the effects of the exchange on the Colorado insurance market.  The RFP was titled, “Independent Consulting Firm to Conduct Background Research to Support the Development of the Colorado Health Benefit Exchange.”  Gruber was awarded the contract, briefed CHI on the basics of his findings in September, and published his final report in January of 2012.

The Legislature had already adopted SB11-200 which created the exchange.  Nevertheless, the paper has been cited in a number of different policy discussions, from a Colorado Department of Public Health and Environment brief on unintended pregnancy to a February 2012 article in Health Affairs titled, “Colorado’s Health Insurance Exchange: How One State Has So Far Forged A Bipartisan Path Through The Partisan Wilderness.”  The paper was cited in a July 2012 assessment of state exchanges by the Commonwealth Fund (Unfortunately for Commonwealth, its glowing assessments of Maryland’s efforts weren’t born out when the exchange actually launched.)

While the paper didn’t influence the state’s decision to launch a state exchange, it was cited in a Colorado Health Foundation paper pushing for full state Medicaid expansion.  That paper was released in February of 2013; the bill to expand Medicaid, with the federal government picking up most of the initial tab, was passed in that legislative session (SB13-200).

At the moment, several questions remain: how much did the Colorado Health Institute pay Gruber for his work?  Gruber’s going rate for this sort of analysis has varied from under $100,000 to nearly $400,000.  Was this analysis tax-payer funded?  Other than the Colorado Health Foundation paper, what role did the report play in encouraging the state to fully expand Medicaid?  Are the full model and data used in the Colorado analysis available for inspection?  Were those using his analysis aware of his prior failure to disclose his conflicts of interest?

Given ACA’s supporters’ history of citing consulting they funded as independent and objective during policy debates, and the cost both of the state exchange and the Medicaid expansion, these are questions that demand answers.

Image Source: Shutterstock

Reposted by  11/21/2014

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