The biggest loser.

The biggest loser.

States refusing to expand Medicaid under the Affordable Care Act will lose more than $35 billion collectively in federal funds by 2022, and cost their taxpaying citizens more.

That's from a new report from the Commonwealth Fund.

Not expanding Medicaid is not a rational decision for any state. But there are some very big losers: Texas ($9.6 billion), Florida ($5 billion), Georgia ($2.9 billion), Virginia ($2.8 billion) and North Carolina ($2.6 billion). The citizens of those states will continue to "bear a significant share of the overall cost of the expansion through federal tax payments," the report says, while they will "not enjoy any of the benefits."



So red state residents are paying the federal taxes that help support Medicaid expansion everywhere but at home. More than that, they're losing the community hospitals that they rely on for timely medical care, especially in emergencies. They're losing out on other economic development opportunities because their states have to pour more money into the system broken by having so many uninsured.

At some point, those people are going to realize their state governments are shafting them. That's what Republicans should be fearing, now that there isn't going to be any Obamacare repeal. Right now, they're scared that Obamacare's success is going to create a lot more Democrats. But, in the case of Medicaid expansion, it's going to be Republican failure that does it.