The latest report from the Commonwealth fund on how much states are losing by not accepting Medicaid expansion funding is circulating among the health wonk punditry. It should also be circulating among the political chatterers, too, because it's a pretty stark reminder of just how much damage Republican governors and legislatures are inflicting on their states and their people in the next decade.

Just check out this graphic that ran Friday in The Washington Post, illustrating the net loss these states will suffer because of their decision.

No state, the study concluded, that is rejecting Medicaid will actually save money in the next decade, even after the federal reimbursement rate drops from 100 to 90 percent. That's because they're still on the hook for a lot of uncompensated care: paying for the health care of all those people who still aren't covered. The study also points out that the citizens of those states will be paying federal taxes that go, in part, to the expansion of Medicaid that they won't see the benefits from.

Between that, and the fact that hospitals are closing in these red states because they can't keep affording to provide uncompensated care, Medicaid refusal is going to become a potent political issue.