This article is part of Ad Watch, a series examining claims made in political ads. In the column, reporter Lindsay Weber researches the claims, puts them into context and reaches a “verdict” on the accuracy of the claims. If you have an ad for us to factcheck, email liweber@mcall.com with Ad Watch in the subject line. View all our election coverage at mthemorningcall.com/election.
The race
Pennsylvania’s 7th Congressional District is considered one of the most competitive in the country, and a key seat in determining which party controls the House of Representatives. The margins of elections have been razor thin in recent years — Republican Ryan Mackenzie ousted Democrat Susan Wild by just one percentage point, or 4,000 votes, in 2024, and Wild, in 2022, was reelected to a third term by a slim two percentage point margin, or around 6,000 votes.
Mackenzie, who so far is running unopposed for the GOP nomination, will face one of five Democrats who have lined up for the nomination to run against him.
Democrats are aiming to harness perceived anger at the GOP for forthcoming cuts to some social programs and a still-stagnant U.S. economy, while Mackenzie is touting economic progress and immigration crackdowns in his pitch to 2026 midterm voters.
Congressional races in the Lehigh Valley often see major spending and ads from outside groups that are not directly affiliated with the candidates’ campaigns. In 2024, spending from outside groups on the Lehigh Valley election outpaced spending from the candidates’ campaigns, according to Open Secrets.
The ad
A black screen with a voiceover and matching text reads: “You are hearing a lot about Medicaid these days, so let’s get the facts.”
It goes on to claim that “there are no cuts to Medicaid in the new law Congressman Ryan Mackenzie voted for,” and features a photo of Mackenzie. It claims the law, the One Big Beautiful Bill, “incentivizes states to prioritize caring for the needy, including low-income children and the elderly, and establishes work requirements for able-bodied adults to reduce waste, fraud, and abuse.”
It includes visuals depicting children, the elderly and a stock video of a dollar bill burning with fire, symbolically depicting perceived waste, fraud and abuse.
The ad ends saying “those are just the facts,” and asks viewers to call Mackenzie and thank him for “strengthening Medicaid.”
The ad is funded by the American Prosperity Alliance, a 501(c)4 nonprofit that is affiliated with former Republican Speaker of the House Kevin McCarthy, according to a Politico report. Such groups are sometimes referred to as “dark money” organizations because they can raise and spend unlimited amounts and are not required to disclose their donors.
Mackenzie’s campaign is not directly involved in the ad. Candidate campaigns are legally barred from coordinating with outside political groups in most cases.
Analysis
The ad cites an article from the Paragon Health Institute, a right-leaning health care think tank led by Brian Blase, a former special assistant to President Donald Trump for economic policy from 2017-19, during Trump’s first term.
The Paragon Health Institute article calls Medicaid cuts a “myth,” and claims that the Big Beautiful Bill instead slows the growth of Medicaid spending over time, rather than “cutting” the program.
The Paragon Health Institute article cites figures from the Congressional Budget Office, as well as its own data estimates, that show that the changes, set to take effect in 2027, will slow the growth of federal Medicaid spending. The article also claims that 12 million people are “improperly enrolled” in Medicaid or Affordable Care Act insurance programs.
Medicaid is a joint federal and state health insurance program that provides health care coverage to low-income people, families, children, disabled people and seniors. The program was established under President Lyndon B. Johnson in 1965, but was significantly expanded via the Affordable Care Act, a signature piece of legislation from President Barack Obama’s first term in 2010.
The ACA expansion meant that nearly all adults with income 138% or below the federal poverty level could qualify for a Medicaid plan, although that expanded eligibility has only been adopted by 40 states and Washington, D.C., according to KFF. Generally, who is eligible for the program varies by each state, which administers the program via state and federal funds.
Around 70 million Americans rely on Medicaid for their health insurance.
The One Big Beautiful Bill Act, passed by Congress and signed into law by Trump in July, will significantly reduce the amount of people eligible for the program.
The new law implements work requirements for able-bodied people who receive Medicaid, requiring them to prove to the government that they work, job search or participate in job training programs for at least 20 hours a week, with some exceptions.
Republicans have lauded the work requirements as a commonsense reform. However, critics have said that the requirement creates excessive and burdensome paperwork requirements for Medicaid recipients and states that must vet them, and point to the fact that some states that have implemented similar requirements have not meaningfully reduced unemployment.
Looking at the numbers in isolation, Medicaid spending will continue to increase in future years, hence the ad’s claim that there are “no cuts” to the program. According to KFF, states expect Medicaid spending to continue to increase despite the Big Beautiful Bill’s cuts to the program due to the increasing health care needs of recipients and the growing cost of care, among other factors.
However, the claim that there are “no cuts” is misleading. According to projections from the Congressional Budget Office, a nonpartisan federal research agency, the bill will cause 10.9 million people to lose Medicaid health insurance by 2034. The Congressional Budget Office estimates that spending on Medicaid will be reduced by $793 billion over the next 10 years, compared with spending projections prior to the Big Beautiful Bill’s passage.
The One Big Beautiful Bill cuts Medicaid as it exists today, because it reduces the amount of spending needed to keep its current enrollment numbers. Therefore, it is misleading to call Medicaid cuts a “myth,” or claim that the bill does not cut Medicaid.
Paragon Health Institute’s claim that 12 million are “improperly enrolled” is disputed by the American Hospital Association, which claims that Paragon incorrectly assumes that people on Medicaid or other marketplace health insurance programs who do not file any claims are fraudulently enrolled, among other issues they cite with Paragon’s research.
Mackenzie voted for the One Big Beautiful bill and vocally supported its passage, and specifically called the implementation of work requirements a “commonsense reform.”
However, he has joined with a group of Republican lawmakers who seek to extend premium tax credits for Marketplace health insurance programs. Millions of people who buy insurance plans on the ACA Marketplace (not Medicaid recipients) will see their premiums spike in 2026 because federal subsidies for such programs have expired, and Speaker Mike Johnson has refused to call a vote to extend them.
Verdict
The ad is misleading because it claims that there are “no cuts” to Medicaid, even though several studies show that millions of people are expected to lose their health insurance due to the One Big Beautiful Bill.
Even though year-over-year spending on Medicaid is projected to continue to increase, it will do so at a reduced rate because fewer people will receive health care coverage under the changes to the program.
Reporter Lindsay Weber can be reached at Liweber@mcall.com.
