In fact, the CBO has said that overall the health care bill actually reduces government spending by about $124 billion over 10 years.PolitiFact makes this claim in the context of a story about spending under the Accessible Care Act, also known as ObamaCare.
PolitiFact doesn't use "spending" normally, here.
People use "spending" to refer to outlays. If you make $2000 per month and spend $1500 on rent and essentials while saving $500, your spending for the month is $1500. PolitiFact would have you count your income against your expenses and find that you spent -$500 for the month. But that's a budget surplus, not a reduction in spending.
It's misleading to present a budget surplus or deficit as a spending figure.
No serious person thinks the ACA reduces spending.
The closest to that we can get comes from crediting the ACA with reducing the increase in Medicare spending. We'll ignore the cautions from Medicare's chief actuary that the projections are unrealistic. Here's what the left-leaning Center for American Progress says about Medicare savings:
$424.4 billion: The amount of federal deficit reduction from 2010 to 2019 due to changes in Medicare coverage and payment rules under ACA. These include limits on annual rate increases for hospitals and other health care providers.
This CBO report may represent the source of PolitiFact's claim:
In March 2010, CBO and JCT estimated that PPACA and the provisions of the Reconciliation Act related to health care would produce a net reduction in federal deficits of $124 billion over the 2010–2019 period as a result of changes in direct spending and revenues.Drop the part about "revenues" and it makes for an ObamaCare-friendly soundbite. The CBO figures the ACA as a deficit reducer not because of decreased federal spending but because of tax increases combined with the accounting trick (built into the CBO's standard methodology) of not foreseeing changes to statutorily mandated decreases in health care provider reimbursements under Medicare (see the "doc fix"). The CBO has to pretend that the "doc fix" will not occur even though it very probably will occur regularly.
PolitiFact's misstatement is the stuff of misleading political ads. But they call it fact checking.