Today's USA TODAY had a front page story on how the states are splitting along a purely political Republican-Democrat divide on whether to expand Medicaid in the way it was designed in the now legal ObamaCare. At this point, fourteen states with Democratic governors are moving forward with adoption; seven more are waiting. None of the states with GOP governors have adopted the changes, with seven saying they definitely will not and twenty-two others waiting.

So who's going to suffer? The 'GOP states' have more than 10 million people who will have no healthcare other than hospital emergency rooms who will provide care without being paid. Without broad action by the states, millions of Americans will remain uninsured, hospitals will face continued demands for uncompensated care, and private health insurance companies will certainly announce major hikes in premiums.

So other than the people in the Republican-governed states who will continue to have no health insurance, who will suffer? Who will pay?

The health insurance companies set up insurance programs by creating individual companies in each state. They do that because insurance is normally regulated by state insurance commissioners on a state-by-state basis. The terms of policies issued in each state and the premiums charged result from the insurers submitting their experience in each state to the state commissioners. They can't use high claim experience in New York as an example, to justify premium increases in Mississippi.

So who's going to pay for those millions of uninsured people? The other residents of those GOP-governed states who for mostly political reasons are refusing to let their state participate in the newly-designed Medicaid program...that's who!

What about Florida? Governor Rick Scott has already announced that Florida will not participate in the "new Medicaid". He's also said he would block the creation of an insurance exchange to encourage more private companies to compete for the business of Florida residents. Pretty much a party-line position. (Maybe it's even a personally-driven position. Scott had a felonious Medicare fraud experience when he was CEO of Hospital Corporation of America. And he still owns Solantic, a company trying to be an alternative to hospital emergency rooms. Might Scott personally have a "dog in this fight", making decisions for Florida residents for personal gain? Just wondering.)

The cost of Medicaid in Florida is growing at a rate 3-1/2 time faster than the state's general revenue. You can read the "fix" to that problem only two ways--increased taxes or elimination of service. Its reasonable to expect that a large number if the 3.19 million currently on Florida Medicaid will be kicked out as the result if the state's inability to fund the program. Where will they get care? Back to those hospital emergency rooms, who don't get paid for the care they provide. Or maybe the families of those with no money and no Medicaid will be required to pay. Increasingly, states are "reaching out" to demand payment from sons, daughters and other family members of indigent Medicaid patients to require payment.

Then the next step, obviously, is the insurance companies (really only one major one in Florida--United Healthcare) seeking major premium hikes, which almost certainly will be approved. So who's going to pay for the politically-driven recalcitrance? Why those of us with private insurance policies, obviously. Expect your premiums to skyrocket.

This is better than a single payer system? This will provide for better health results of the tens of millions of Americans with no insurance? This is affordable by the people who are paying for insurance?

In the meantime all that our feckless Congress has found time to do is pass a bill to repeal ALL of the ACA...and hold hearings on the problems of medication of racehorses!

C'mon all you small government conservatives out there...tell me how this is good for America...good for Americans...or affordable by Americans? Other than just saying, "repeal ObamaCare" and asserting that "we already have the best healthcare system in the world", what's the answer to this problem? What candidates from either party for any office is proposing a fix? C'mon tell me how and why politicizing the health of tens of millions of Americans is a good thing? Get your head out of the sand...or some other dark place.