Obamacare is many things. One of which is an interesting natural experiment in determining whether states shooting themselves in the foot makes it harder or easier to walk than states that don’t shoot themselves in the foot.
When PPACA passed in March 2010, the basic cash flow model would have seen increased taxes (income tax surcharges, Cadillac plan taxes, medical devices, tanning tax etc) from richer and usually bluer states as well as Medicare Advantage clawbacks from a variety of places. The Medicare Advantage clawbacks would apply to everyone but areas with higher Medicare Advantage utilization would see greater net reductions. This money, either new from taxes or reprioritized from Medicare Advantage would then go pay for either Medicaid expansion or coverage/cost-sharing subsidies. Regions with very low pre-PPACA Medicaid eligibility thresholds and high uninsured populations such as Mississippi would see more new Federal money than states with high Medicaid thresholds and low uninsured populations like Massachusetts. Massachusetts would pay more and proportionally get less back. That is expected, it is how every single social welfare program in this country works.
Obamacare in an import-export regional economic modeling viewPost + Comments (79)