Counting the Obamacare Beans

I want to call your attention to Obamacare in an import-export regional economic modeling view by Richard Mayhew at Balloon Juice. It begins:

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.

He then goes on to explain in a wonderfully wonky-snarky way that the states denying Medicaid expansion are hurting themselves financially.

Unsurprisingly states that expanded Medicaid are seeing uninsured rates drop dramatically as well as more robust local economy as they are now receiving an “export” cash flow of .5 to 1% of gross state product from the federal government. That will spin out to four or five local jobs in “secondary” industries from each job in healthcare that is being created or sustained by Medicaid expansion. Non-expansion states are seeing cash outflows in increased taxes or lower Medicare Advantage payment rates without any corresponding cash inflow. Their hospitals are still seeing high numbers of uninsured patients as other compensating funds have been cut. They are in trouble.

He also says,

Finally, if Halbig is upheld by the Supreme Assholes, we’ll quickly see half the states that would be screwed do the Gaba two-step of buying a new web domain name to use as a splash page and then getting the summer IT intern redirecting visitors from that splashpage to These states would see no change, while the Confederacy and Great Plains Republican base states would take multi-billion dollar hits in order to save $200 for a domain and a redirect.

this was interesting to me, because a guy at the Washington Examiner predicted something else–

The (currently delayed) requirement for larger businesses to purchase insurance for their workers or pay penalties is triggered in cases in which at least one employee obtains government subsidies to purchase insurance. In states where subsidies cannot be distributed, the penalties won’t apply. Therefore, a ruling against the government in Halbig could set up a scenario in which businesses want to flock to states with federal exchanges as a way of getting around the employer mandate.

I don’t doubt that some states actually would refuse to set up a domain, and would then sit back waiting for all these employers to stampede across their borders on the promise of cut-rate employees. Whether that would actually happen I do not know. I am inclined to think that a business that would go to the expense of relocating just to go cheap on employees is not necessarily the kind of employer who will help build a better future for your state, but that’s me.

2 thoughts on “Counting the Obamacare Beans

  1. I wonder how John Roberts feels about this?
    It’s his Medicaid mess.
    While the other four Fascist sociopaths (naturally) voted against making PPACA legal, Roberts was the one who gave states the Medicaid opt-out.
    I hope his Sunday Communion wafer and his wine taste bitter.

  2. Reading through Philip Klein’s article, we are looking at different things. I’m looking at basically a macro-viewpoint while he is looking at a micro viewpoint. Furthermore, he is really looking at low wage, low benefit, low productivity industries where not offering health insurance is not a deal breaker. He is effectively advocating for a continuation of the WalMart/Southern (non Research Triangle, non-Beltway Bandit, non-massive hydrocrabon extraction) economic strategy of “winning” the race to the bottom against Blue States.

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