The 23 states that have refused Medicaid expansion under Obamacare will be sending $152 billion in taxes paid over the next 10 years to states that did expand. That's from a McClatchy analysis of Urban Institute data. Among the states that will be really losing out, is North Carolina, which will shell out about $10 billion.
Taxpayer contributions, estimated at $10.2 billion from North Carolina and $3.1 billion from South Carolina, won’t change regardless of participation. But as things stand, only the 27 states (along with Washington, D.C.) that expanded Medicaid or created their own programs are sharing in the benefits. […]That's not even counting the negative economic impact that the state is experiencing because of hospital closures. The 23 states that didn't take the expansion money are losing out on $170 billion just in payments to hospitals, and at the same time those hospitals are having to absorb cuts. When the law was written, hospitals agreed to take some cuts under the assumption that they would make up the difference by having fewer uninsured patients. That was before the Supreme Court decided that states didn't have to take the expansion. Now those cuts are hitting and the hospitals are still having to treat the uninsured.
Medicaid looms at the top of the agenda when the North Carolina legislature convenes in January. What’s unclear is whether Republican leaders will reconsider their refusal to accept the federal money.
This year, Senate leaders clashed with Gov. Pat McCrory and House leaders over plans to control medical costs and improve the state Medicaid system. None of them called for expanding Medicaid.
That problem, and state and local business support for expansion could make the difference in North Carolina and some of the other states. That's why states like Wyoming, and Tennesee, and Indiana, and Connecticut—and even Utah—are exploring expansion. Pretty soon they're going to discover that they can't afford not to.