One of the main provisions of the Affordable Care Act is the federally sponsored Medicaid Expansion, giving coverage to Americans in states opting into the expansion earning 138% of the poverty level. The expansion for each state will be paid for mostly by the federal government, 100% through 2016, and 90% by 2020. States that opted out of the expansion, however, will not only miss out on covering much of their uninsured, but will have their citizens paying into the system without seeing the benefit themselves. Below is a map of states opting out of or undecided about the Medicaid Expansion and the per capita loss of federal funds they will see in 2022 as their citizens pay for other states.
(Note: Data is calculated assuming all other states participate in Medicaid expansion with funding raised through federal revenue collection of personal income. Net loss accounts for new federal spending for those currently eligible for Medicaid who newly enroll.)
Source: How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion