My job back then was as a staff writer for the city's alternative newsweekly, the Boston Phoenix. And after Romneycare (as no one called it at the time) went into effect, one of my stories went looking for reaction to the law from a demographic – twentysomething bike messengers, waitresses, etc. – that the media often ignore.

[Political Malpractice: Will health IT bipartisanship survive the elections?]

Despite the fact that Romney's administration set up an independent public authority, the Commonwealth Health Insurance Connector Authority (a.k.a the Health Connector) to essentially be a broker, helping folks without coverage find a plan that fits them and their income, many of these young – and often very liberal – people were ticked off about the "individual mandate" and objected to the plan on general principle.

"@#$% ’em," said one guy I interviewed. "I don’t care."

Back then, I wrote that Romney's "groundbreaking" legislation had the "potential to momentously influence the national insurance debate." Little did I know I'd still be writing about it five years later – not to mention that the governor who signed it into law with that huge grin on his face would be doing everything possible to distance himself from it.

It's ironic. Since 2006, the Massachusetts health reform "has been successful,” Gruber says. “Our law had two goals: One was to cover the uninsured, and we've covered about two thirds of the uninsured, and the other was to fix a broken non-group and non-employer insurance market, and in that market we've cut our premiums in half, relative to national trends."

What the legislation hasn't done is control costs. "Overall healthcare spending in Massachusetts has grown at just about the national average since we passed our law – but that wasn't a goal of the law,” Gruber points out. “So we've done what the law was supposed to do and haven't done what the law wasn't supposed to do."

Moreover, he says, "We've done it with very broad public support. We have about two thirds public support in Massachusetts."

I mention the defiant reactions I got when I wrote that article five years back; the people who angrily rejected the law's mandates.

"I was worried about that too," Gruber says. "It's been a real accomplishment of the Connector and its administrative staff and its media staff to explain to people why it's necessary."

Obama not avowing ACA benefits
If there's one thing the Obama administration has not done well, it's explaining to people why the Affordable Care Act is necessary, or which benefits they are already enjoying.

Gruber admits he was "surprised" by the sound and fury, the wailing and gnashing of teeth that greeted the Obamacare law he helped devise.

"I knew there would be opposition," he says. "I'm surprised that the politics haven't been able to break through more on the benefits for people. But the benefits have to take place. People have to be able to see them and touch them before they believe in them."

So if Romneycare is working as advertised after five years on the books, how will Obamacare be working half a decade after its key provisions take effect in 2014?

"I think it's going to be very successful," Gruber says. "I don't know if it's going to be as successful [as Romneycare has been in Massachusetts]. Partly, it won't cover as many uninsured, because the ACA doesn't cover illegal immigrants and Massachusetts doesn't have many of those."

[Q&A: A public hospital CEO's concerns about SCOTUS, November elections.]

The big issue, however, will still be opposition to the mandate. "My one worry is that even if it passes the Supreme Court, and even if Obama is reelected,” Gruber continues, “the biggest threat is going to be on-the-ground opposition to the law, and opposition to the mandate could undermine it."

Gruber expects the law to be upheld by the Court, "because it's the right thing to do."

But there's no question that by the time you read this article, SCOTUS may have already made this whole conversation moot by striking down the law.

If that happens, "I think we're going to retrench. We ran that experiment in 1994 [with the Clinton healthcare plan],” Gruber says. “With little incremental expansions we'll keep piddling along, but I think it just gets harder and harder to do it. Every time it gets killed, it gets harder and harder to move forward."

Related Political Malpractice coverage:

Health costs highest on Americans' top 10 issues list

Are politics extinguishing state health insurance exchanges?

They all chant 'ACA repeal' but what could a GOP president actually do?

Podcast: SCOTUS and ACA, what we know, what we don't, why each matters

Newt Gingrich on health IT: Then, now, and the days between

For more of our politics coverage, visit Political Malpractice: Healthcare in the 2012 Election.