Ezra Klein writes for Vox of the paradox of Obamacare — it is a massive subsidy for areas of the country that hate it most, because it favors poor people. And the more successful Republicans are at fighting it and resisting participation, the bigger a subsidy it stands to become for blue states.
Bottom line if Republicans are successful with the latest big legal challenge:
Now the Supreme Court will take up King v. Burwell, in which the plaintiffs argue that the text of the Affordable Care Act makes it illegal for subsidies to flow through federally-run exchanges. If they’re successful, then it will be possible for a state that opposes to Obamacare to withdraw from both the Medicaid expansion and the exchange subsidies — that is to say, from pretty much all of Obamacare’s benefits. But they will still pay all of its costs. They will still pay the law’s taxes and their residents will still feel the law’s Medicare cuts. Obamacare will become a pure subsidy from the states that hate the law most to the states that have embraced it. It’s like a fiscal version of reverse psychology.
In Arkansas, thanks to some uncommonly far-sighted Republicans, we adopted Obamacare in a hybrid form. But it remains to be seen if the bigger, more conservative Republican majority — swollen by dedicated Obamacare opponents — will continue the state’s participation. Then Arkansas, too, could pay all of the taxes with none of the benefits.
This simple fact — paying a lot for nothing — is why most people think Asa Hutchinson inevitably must use his honeymoon as the new governor to bring his party on board for continuation of the private option version of Obamacare and our health exchange partnership with the feds. That and his need for the Obamacare money to trickle down into other aspects of government.