PolitiFact: Weatherford overreaches with claim that Medicaid expansion drives deficit

The Florida House did the nation a favor by refusing to expand subsidized health insurance to 1 million low-income Floridians, argues Speaker Will Weatherford.

"Congress has not passed a budget in four years, and each year the federal government spends over a trillion dollars more than it has, leading to a national debt approaching $17 trillion," Weatherford, R-Wesley Chapel, wrote in a recent op-ed column. "Expanding Medicaid would require borrowing more money, drastically expanding our deficit."

Does the Medicaid expansion drastically raise the deficit? PolitiFact Florida wanted to check it out.

Weatherford spokesman Ryan Duffy responded to our inquiry with a document that includes a Wall Street Journal op-ed by Christina Corieri, a health care policy analyst at the Goldwater Institute, a free-market research group that opposes the expansion of Medicaid.

Corieri's column does not say that expanding Medicaid as outlined in the health care law will drastically increase the deficit. Instead, Corieri says states have "the unique opportunity to veto hundreds of billions of dollars in new federal spending." She said the nearly 30 states that have either opted out or are considering it could save the government $609 billion over the next eight years.

"The more than $609 billion in total savings from these 30 states would represent over 50 percent of the expected federal spending on the Medicaid expansion," she wrote. "A drop in the bucket? That's more than seven times the $85 billion in 2013 sequester cuts and more than half the projected federal deficit for this fiscal year."

We sought our own answers, starting with the nonpartisan research arm of Congress, the Congressional Budget Office. CBO has not assessed our specific inquiry about how the Medicaid component of the law influences the deficit, but the office has evaluated the short- and long-term cost of the whole health care law a few times.

In short, what CBO determined is the law as a whole reduces the deficit, and repealing it would increase the deficit.

Why? Because what the government will pay out to subsidize health insurance for the uninsured, through tax credits to go on health exchanges or for Medicaid, will be more than offset by reduced payments to Medicare providers and insurers as well as new taxes on high-income earners and the health care industry, said Edwin Park, vice president for health policy at the left-leaning Center for Budget and Policy Priorities.

Experts, however, differed on how much weight to put into the analysis of the entire health care law when considering Weatherford's more narrow statement.

Park considers the CBO estimate of the health care law key to our research.

But Corieri said CBO has not factored in how removing some unpopular taxes from the law, such as a tax on medical devices, would affect the bottom line. She also questioned CBO's including time before the law takes full effect in 2014 into its analysis.

Marc Goldwein, senior policy director of the Center for a Responsible Federal Budget, said CBO's analysis does not factor in which specific states will expand coverage, so it's impossible to know whether states such as Texas and Florida, which are not expanding Medicaid, were included. CBO assumed 70 percent of beneficiaries would be in states that opted to expand.

As for Weatherford's statement, Goldwein says it's accurate to say expanding Medicaid would require borrowing more money "so long as you qualify, that means more money than would otherwise be borrowed." Goldwein said it's hard to assess the "expanding the deficit" part of Weatherford's statement.

"That really raises the question — compared to what?" he said.

Steve Ellis, vice president of Taxpayers for Common Sense, took a broader read of Weatherford's claim, saying the health care law is too complicated to tease out the budgetary impacts of any one policy without noting the impacts elsewhere.

"The speaker talked about it as if expanding Medicaid was the only policy change, instead of being coupled with many others in a package that had net deficit reduction and wouldn't require borrowing more money or expanding the deficit," Ellis said.

Our ruling

Weatherford defended his key role in blocking federal money to help insure more low-income Floridians by pointing to the effect of all that extra health care spending on the national deficit.

There's no doubt the federal Medicaid expansion will cost money. Weatherford's commentary, however, is vague.

He ignores nonpartisan research showing the cost of expanding Medicaid coverage is offset by other parts of the health care law. At the same time, saying Medicaid expansion will "drastically" enhance the deficit is unproven.

The claim hits a note about federal spending but omits key information. We rate it Half True.

This fact-check has been edited for print. Read more at PolitiFact.com/Florida.