by Gregory Nickerson

A poll conducted by the Florida-based Foundation for Government Accountability, a conservative think tank, asserts that 70 percent of Wyomingites disagree with Medicaid expansion “once they understand it’s being funded with $716 billion in Medicare cuts to seniors.” The group has also created the website urging the governor to reject Medicaid expansion, and submitted opinion columns to media outlets such as Forbes.

Critics say those claims on Medicare cuts exaggerate the facts. The Affordable Care Act is partly funded by cuts to the Medicare Advantage program, a limited-network portion of Medicare that pays 12 percent to 15 percent more benefits than traditional Medicare, and is subsidized by those who pay into the Medicare A and Medicare B plans.

According to Mike Fierberg, spokesperson for the Denver Regional Office for the Centers for Medicare and Medicaid Services, Congress decided it unfair for the Medicare Advantage program to be subsidized by other participants. As part of the ACA Congress chose to step down the benefits over the next few years, and provide some of that revenue to support Medicaid.

The total in Medicare Advantage benefits lost to Wyoming residents on Medicare Advantage is likely a fraction of the $784 million cited by FGA, and it will be spread out over several years, Fierberg said. A 2011 study cited by FGA, which Fierberg said is likely out of date, estimated about $47 million in reduced benefits for about 6,000 seniors on Medicare Advantage in Wyoming through 2017. Those seniors would still get benefits, just not at the 12 percent to 15 percent rate above that of other Medicare recipients.

The group further claims that expanding Medicaid would “put at risk critical investments for roads, school and public safety.” Given the complexities of Congress’ funding decisions, such predictions for funding flows are uncertain, even as the country holds $17 trillion in debt.

“That’s something we don’t have any information on,” said Kim Deti, of the Wyoming Department of Health. “Decisions on federal funding are not made here. But as far as state General Funds that Wyoming can control, we are talking about it being budget-neutral.”

Another point made by FGA is that, “ObamaCare’s Medicaid expansion gives free, taxpayer- funded health care to working-age, able-bodied adults with no kids and no reason they cannot support themselves.”

The Department of Health estimates that 59 percent of Wyoming’s Medicaid expansion population are currently employed. More than a third of those employed work more than 40 hours each week.

The Wyoming Department of Health estimates that 59 percent of the 17,600 people in the “best estimate” expansion population are working and making an effort to support themselves. Many of these Wyoming residents are underemployed, or working minimum wage jobs that provide up to 138 percent of the federal poverty level. Some are supporting their adult children who are disabled. When uninsured, the cost of medical care can quickly run up debt that is difficult to pay off, causing hospitals to shift the costs to those who are insured.

FGA argues that Medicaid expansion would put, “Felons First: More than 1 in 3 of ObamaCare’s Medicaid expansion enrollees have a criminal record, including time served in prison or jail.” A 2011 Dept. of Justice report cited by FGA estimates that up to 35 percent of the Medicaid expansion population could have “a history of criminal justice system involvement.” However, felons would get no special provision under Medicaid expansion.

Herman criticized the Foundation for Government Accountability survey, calling it, “A poll manufactured from the national political agenda of people who are unconcerned about thousands of low-income people in Wyoming. … The questions use a false premise talking about use of Medicare information, and the results are useless because it is push-polling which is intended not to find out opinion, but to change opinion. … We need our policy and lawmakers to find a good policy, and to leave the politicking to the folks in Florida and the folks in Washington DC.”

An expert in polling at the University of Montana said the poll did not represent an accurate slice of Wyoming’s population because it was heavily weighted toward the elderly. It also questioned the poll’s usage of the term “Obamacare,” a politically-loaded word, that while used by President Obama himself, may have been included to create a negative reaction.

The Foundation for Government Accountability’s is a 501(c)3 nonprofit based in Naples, Florida, that undertakes work across the nation. Revenue on their IRS 990 form climbed from $700,000 in 2012 to $1.9 million in 2013. They spent $742,000 on the Uncover Obamacare project in 2013. The Wyoming effort is part of that campaign for year 2014.

One of FGA’s principal funders is Donors Capital Fund, an Arlington, Va., donor-aggregator group that raised $60 million in 2013. It granted $213,500 to the Foundation for Government Accountability in 2012.

Donors Capital Fund also gave $240,000 to the Wyoming Liberty Group in 2009, $230,000 in 2010, and $15,000 in 2011.

Foundation for Government Accountability did not respond to a WyoFile question regarding the group’s source data for Medicaid Advantage cuts.

IRS 990 data in this story made available by Citizen Audit, the nation’s only freely available full-text searchable database of full digitized nonprofit financials, with text extracted from PDFs through optical character recognition.

— Gregory Nickerson is the government and policy reporter for WyoFile. He writes the Capitol Beat blog.