Patient Protection and Affordable Care Act in the context of "Pre-existing condition"

Jonathan Holmes Gruber (born September 30, 1965) is an American professor of economics at the Massachusetts Institute of Technology, where he has taught since 1992. He is also the director of the Health Care Program at the National Bureau of Economic Research, where he is a research associate. An associate editor of both the Journal of Public Economics and the Journal of Health Economics, Gruber has been heavily involved in crafting public health policy.

He has been described as a key architect of both the 2006 Massachusetts health care reform, sometimes referred to as "Romneycare", and the 2010 Patient Protection and Affordable Care Act, sometimes referred to as the "ACA" and "Obamacare". He became the focus of media and political controversy in late 2014 when videos surfaced in which he made controversial statements about the legislative process, marketing strategies, and public perception surrounding the passage of the ACA.

Americans for Prosperity (AFP), founded in 2004, is a libertarian conservative political advocacy group in the United States affiliated with brothers Charles Koch and the late David Koch. As the Koch family's primary political advocacy group, it has been viewed as one of the most influential American conservative organizations.

After the 2009 inauguration of President Barack Obama, AFP helped transform the Tea Party movement into a political force. It organized significant opposition to Obama administration initiatives such as global warming regulation, the Patient Protection and Affordable Care Act, the expansion of Medicaid, and economic stimulus. It helped turn back cap and trade, the major environmental proposal of Obama's first term. AFP advocated for limits on the collective bargaining rights of public-sector trade unions and for right-to-work laws and opposed raising the federal minimum wage. AFP played an active role in achieving the Republican majority in the House of Representatives in 2010 and in the Senate in 2014.