Secretary of State John Kerry gamed Obamacare while senator for Massachusetts. He considers Nantucket a rural place. What a joke. Kimberley Strassel of The Wall Street Journal explains why here:
At issue are the dollars that Medicare pays to hospitals for the wages of doctors and staff. Before the new health law, states were each allocated a pot of money to divvy among their hospitals. The states are required to follow rules in handing out the funds, in particular a requirement that state urban hospitals must be reimbursed for wages at least at the levels of state rural hospitals.
Enter Mr. Kerry, who slipped an opaque provision into the Obama health law to require that Medicare wage reimbursements now come from a national pool of money, rather than state allocations. The Kerry kickback didn’t get much notice, since it was cloaked in technicality and never specifically mentioned Massachusetts. But the senator knew exactly what he was doing.
You see, “rural” hospitals in Massachusetts are a class all their own. The Bay State has only one, a tiny facility on the tony playground of the superrich—Nantucket. Nantucket College Hospital’s relatively high wages set the floor for what all 81 of the state’s urban hospitals must also be paid. And since these dramatically inflated Massachusetts wages are now getting sucked out of a national pool, there’s little left for the rest of America. Clever Mr. Kerry.