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Sorting out the truth in state politics

PolitiFact Florida: Fact-checking Gov. Rick Scott on the health care law

Gov. Rick Scott opposes the federal health care law, and he wants the world to know it.

So he embarked on a media blitz over the weekend, appearing on Fox News and CNN and Monday, he hosted CNBC's Squawk Box. At each stop, he announced that he had no intention of expanding Medicaid, a health insurance program for the very poor.

He also said he wouldn't allow the state to open health insurance "exchanges," places where consumers will comparison shop for health insurance.

But in expressing his strong opposition to the Affordable Care Act, Scott also got his facts wrong. He gave a misleading account of how much the Medicaid expansion would cost the state, badly misrepresented requirements on small businesses and used a widely debunked talking point about "rationing."

Scott entered the political realm in 2009 by heading up Conservatives for Patients' Rights, a group that attacked President Barack Obama's health care proposals. PolitiFact Florida previously has fact-checked several inaccurate comments from Scott about the Affordable Care Act, including that it is not the "law of the land," that it will be the biggest job-killer ever and that it is the biggest tax increase in the history of the United States. (All were rated False.)

Scott actually fared worse on the Truth-O-Meter this time.

Medicaid expansion

One of the reasons Scott announced that Florida would opt out of an expansion to Medicaid is that the expansion would cost the state an additional $1.9 billion a year. He repeated the figure at least four times in national television interviews, and again in a press release.

Don't believe it.

Scott's Medicaid figure is an oversimplified estimate that relies on several assumptions and ignores how the Medicaid expansion would actually be implemented as part of the health care law. Even if you believe the assumptions and ignore how the law would be implemented, Scott is still quoting the wrong number, according to the most recent estimate created by his own Agency for Health Care Administration.

The health care law required states to expand eligibility to Medicaid by raising income eligibility limits to 133 percent of the federal poverty level. States currently have widely varying thresholds depending on a person's age and situation, and Florida has some of the strictest thresholds in the country. For instance, childless adults cannot receive Medicaid in Florida, and parents who have children must make less than 22 percent of the federal poverty level to receive Medicaid.

The federal government agreed to fund 100 percent of the cost for states to expand Medicaid for three budget years. It would then cover 95 percent of the costs in 2017, 94 percent of the costs in 2018, 93 percent of the costs in 2019 and 90 percent of the costs in 2020 and beyond.

The expansion was technically voluntary, but the federal government said it would penalize any state (by withholding Medicaid funds) that failed to comply. That penalty was declared unconstitutional by the U.S. Supreme Court.

The court's ruling allows states like Florida to decline expansion without losing any current federal funding.

That brings us back to Scott.

The most recent estimate from the state health care agency — from January 2012 — says a series of changes to Medicaid could wind up costing about $1.4 billion a year, but that number includes several things beyond the expansion to Medicaid that Scott was talking about.

For instance, about $400 million is tied to increased reimbursement payments to Medicaid providers. But the state isn't required to pay that out as part of the health care law.

Another $516 million of the estimated $1.4 billion will pay for people who are eligible for Medicaid right now but not yet enrolled. Those people can enroll whether or not Scott gets Florida to opt out of the expansion.

That leaves about $500 million in estimated new costs for Medicaid patients under the federal government expansion.

And that cost — which one health care advocacy group has questioned as "hyper-inflated" — would not fully kick in until 2020.

Scott's $1.9 billion claim appears to be wildly high. We rated his claim False.

20 employees

Scott bungled more basic facts about how the law works.

"I was in a business the other day, and they walked up to me and they said, 'Governor, is this really going to become the law?' " Scott told Fox News host Greta Van Susteren on Friday. " 'Because if it does, we're out of business. We have 20 employees. We know we won't be able to buy any health care for anybody.' "

Scott's story was similar to one he told Friday at the Reagan Day Dinner of Pasco County Republicans. Scott said he was getting a Blizzard at Dairy Queen when he was asked about the law.

We tracked down a Dairy Queen owner in Tallahassee who said he recently talked with Scott about how complying with the law would hurt his business.

Jamshaid Mohyuddin, 47, said he told the governor that he couldn't afford to provide health insurance to his 16 employees.

"I'm a businessman myself, and I don't even have health insurance," Mohyuddin said. "I can't afford it."

Scott encouraged him to link up with other business owners to support Mitt Romney's campaign for president, Mohyuddin said.

But here's the thing: Businesses with fewer than 50 full-time employees are not required to offer coverage.

For larger companies, those with 50 or more full-time employees, there are fines if they do not offer insurance and one of their employees qualifies for government-subsidized insurance.

But again, small employers don't face those fines. We rated Scott's comments Pants on Fire.

Mohyuddin was elated when a reporter told him that the law exempts him from penalties. "That helps me a lot," he said. "I always thought I had to do this."

Rationing care

Scott also repeated claims that the health care law rations care.

"Insurance is not the answer. (The answer is to) drive down the cost of health care," he said Monday on Fox News. "You have insurance in places like (the) U.K. and Canada, where they say, oh we cover you. But you don't get it, because it's rationed. That's what's going to happen."

Scott's answer is problematic on several levels. For one thing, people in the United Kingdom and Canada might have to wait for appointments, but they do receive care.

More significantly, Scott implied that the types of systems in Canada and the United Kingdom are what's going to happen under the current health care law. That's not the case.

In Canada, the government pays the bills for health care for everyone. The closest comparison for this country would be if Medicare (the health insurance program for people over age 65) were extended to everyone. In the United Kingdom, the government runs the National Health Service, directly owning hospitals and employing doctors.

The health care law does neither of those things. Instead, it leaves in place the current systems of Medicare, Medicaid and employer-provided insurance. It expands Medicaid coverage for the very poor, and offers credits to people of modest means to buy insurance on their own. To make those purchases easier, it creates health insurance exchanges, where plans have to meet minimum standards and explain their coverage in plain language.

The bottom line: The health care law rations care no more nor less than the current health care system does.

We rated Scott's statement False.

Times/Herald staff writer Tia Mitchell contributed to this report.

PolitiFact Florida: Fact-checking Gov. Rick Scott on the health care law 07/02/12 [Last modified: Tuesday, July 3, 2012 1:06pm]
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