"When the democrats were writing the Obamacare bill, they knew some states are more conservative than others. They knew that Republicans wouldn't be enthusiastic about this, so they made the terms of medicaid expansion extremely generous. I mean, it's all federal money, and your state, you know, the people that live in Arizona, or Michigan or wherever I mean, they're paying taxes to the federal government one way or the other. Not expanding medicaid doesn't save anyone any money. It just costs your local health care providers and your local citizens a bundle.
The bolded is an extremely important detail. Generally, when we're detailing the negative aspects of states rejecting the medicaid expansion, we tend to focus on the most obvious result: poor people once again get screwed. But as Yglesias pointed out, there's another layer to this.
As conservatives will no doubt love to remind everyone, Obamacare comes with quite a few taxes. These taxes will be paid by people in every state to fund, among other things, the medicaid expansion. But by refusing to accept the medicaid expansion, Red state citizens will be shelling out money to the federal government, but won't necessarily be receiving the benefits that come with it. The money will most likely be diverted to states that will expand medicaid (You know, Blue states).
In other words, every Republican governor and/or Republican legislature who thinks they're socking it to Obama, will in fact only be screwing over their own taxpayers, by essentially subsidizing health care for states like California, Massachusetts and New York! We've seen a similar case before when Florida Govenor, Rick Scott rejected funding for high speed rail.
This presents an interesting conundrum for our friends on the Right. Do they reject expanding medicaid and support the moocher class in Blue states, or do they accept the expansion to support the moocher class in their own states?
Either way, it's a lose-lose situation for Republicans.