From the beginning, the defining irony of the never-ending debate over Obamacare is this: health care is worst in those states where Republicans poll best. The map of the states with the worst health care systems largely mirrors GOP strongholds in the electoral college. Red state residents are generally the unhealthiest and more likely than their blue state cousins to be uninsured. Nevertheless, the New York Times reminded readers on Friday, Republican governors and legislators are rejecting the ACA's expansion of Medicaid that could bring health insurance to millions more of their residents.

As Robert Pear reported, "The refusal by about half the states to expand Medicaid will leave millions of poor people ineligible for government-subsidized health insurance under President Obama's health care law even as many others with higher incomes receive federal subsidies to buy insurance." The cruel ironies don't end there:



Starting next month, the administration and its allies will conduct a nationwide campaign encouraging Americans to take advantage of new high-quality affordable insurance options. But those options will be unavailable to some of the neediest people in states like Texas, Florida, Kansas, Alabama, Louisiana, Mississippi and Georgia, which are refusing to expand Medicaid. More than half of all people without health insurance live in states that are not planning to expand Medicaid.

As you'll see below, the impact of that rejection is staggering.