It's a bit extreme sounding but cities do this with homeless people today, some places will give out one way bus tickets to move homeless people to another city

It's a bit extreme sounding but cities do this with homeless people today, some places will give out one way bus tickets to move homeless people to another city. [0] Even without a Machiavellian "muahaha we'll ship all our sick people to X" good cheap healthcare will attract sick people to a state. It was a problem with the ACA where if enough healthy people weren't paying in [1] insurance companies could go belly up from having to cover sicker people they could previously refuse. That's why there was an individual mandate and a backstop for companies that lost too much money on plans. [0] https://www.theguardian.com/us-news/ng-interactive/2017/dec/20/bussed-out-america-moves-homeless-people-country-study https://www.theguardian.com/us-news/ng-interactive/2017/dec/... [1] In the case of a single state doing a single payer system it's older or simply sicker people who may make less money because of chronic debilitating illness.