Image from: Perrspectives

With Congress set to adjourn for the summer, Republican leaders are hoping to reprise the recess of 2009, when furious Tea Partiers armed with incendiary signs, bogus GOP talking points and occasionally guns (though not the truth) ran roughshod over town hall meetings nationwide. But along with their streams of sound bites and planted questions, the centerpiece of the Republican summer strategy to go "on the offense" against Obamacare is what planners are calling "Emergency Health Care Town Hall" meetings designed to showcase "the negative effects of the health care law and the House Republicans' plan to dismantle it.

But as conservative Byron York and liberal Greg Sargent agree, that tactic could very well backfire on the GOP. After all, as the chart above shows, it is only because of Republican Congressmen and Governors that millions of Americans in the reddest of states will remain without health insurance in 2014.

Though they have voted 37 times to repeal the Affordable Care Act, Congressional Republicans have yet to offer their own proposal to replace it. But 26 GOP-led states sued to overturn the ACA, the Supreme Court gave them one small victory. States could opt out of the expansion of Medicaid to cover American earning up to 133% of the federal poverty level. Now, 24 states have chosen to turn their backs on billions in federal funding and millions of their own residents.

In June, the authors of "The Uninsured After Implementation of the Affordable Care Act: A Demographic and Geographic Analysis" tallied up the Republican body count. For each of the 50 states, the study how many residents would gain health insurance by of the 50 states opting in or out of Obamacare's Medicaid expansion.

The numbers are staggering. In Texas, Governor Rick Perry denounced Obamacare Medicaid expansion as a "fool's errand." But his foolishness in opting out means an extra 1.9 million Texans will needlessly go without health insurance in state where 24 percent of all residents--and 30 percent between the ages of 18 and 64--lack coverage. In Florida, where the GOP legislature is rebuffing Republican Governor Rick Scott's choice to accept the windfall from Washington, another million residents will be left uncovered. (In contrast, over 300,000 more Arizonans will gain insurance, thanks to a rare showing of common sense by Governor Jan Brewer.) Next door neighbors Minnesota and Wisconsin provide another useful case study. While Democrat Mark Dayton will be cutting the ranks of the uninsured by almost half in his state, in Madison Republican Scott Walker is leaving an estimated 182,000 folks out in the cold.

Those numbers aren't lost on Republicans like Governor Brewer and Louisiana Rep. Charles Boustany.

Despite overwhelming GOP opposition in her state legislature, Brewer endorsed the Medicaid expansion, explaining "It's pro-life, it's saving lives, it is creating jobs, it is saving hospitals." Two weeks ago, Dr. Boustany lamented that in his state Governor Bobby Jindal had decided to reject the ACA funding and with it, leave 300,000 in Louisiana uninsured. In Ohio, Republican Governor John Kasich continues to press his GOP legislative majority to accept the Medicaid expansion that would cover an additional 366,000 Buckeye State residents, declaring "I believe it's a matter of life and death." As Kasich warned his GOP colleagues in June:

"When you die and get to the meeting with St. Peter, he's probably not going to ask you much about what you did about keeping government small, but he's going to ask you what you did for the poor. You'd better have a good answer."

Their answer--that Republicans must oppose the Affordable Care Act because President Obama supported it--like won't be sufficient to gain entry through the Pearly Gates. Thanks to GOP rejection of Medicaid expansion, roughly 11.5 million of their constituents will needlessly remain without health coverage. (Preliminary data also suggest that the blue states running their own health insurance exchanges will be able to deliver lower than expected premiums.) Making matters worse, John Boehner's efforts to repeal the entirety of the Affordable Care Act--capping profits for private insurers, shrinking the Medicare prescription drug donut hole, enacting prohibitions on using pre-existing conditions to deny or rescind coverage--would mean all Americans continue to be at the mercy of the insurance industry. And as the numbers clearly show, today health care is worst where the GOP polls best.

That is the real Republican health care emergency.