The NYT had an article on the most recent Republican plan to repeal the Affordable Care Act (ACA). It included a quote from Senator Bill Cassady, a co-sponsor of the bill:
"'Right now, 37 percent of the revenue from the Affordable Care Act goes to Americans in four states' — California, New York, Massachusetts and Maryland, Mr. Cassidy said. 'That is frankly not fair.'"
If just four states getting 37 percent of the money sounds unfair to you, it might be worth keeping in mind that these four states account for more than a quarter of the country's population and GDP. That still means that they are getting a disproportionate share of the money from the ACA, but it is not quite the same as if four small or average size states were getting 37 percent of the money.
It is also worth remembering that ACA spending accounts for roughly 1.5 percent of the total budget. Getting a disproportionate share of 1.5 percent of the total budget doesn't seem like all that big a deal, after all southern states have historically gotten a grossly disproportionate share of the military budget.
Then we have to consider the fact that many states don't get much money from the ACA by choice. Specifically, they have chosen not to expand Medicaid to provide more of their residents with health care insurance. They also have not done much to publicize the exchanges, which would have sent more money to their states through subsidies to moderate income people.
So this is the grave injustice that Senator Cassidy is looking to remedy and to do so he wants to have 30 million plus people lose their health care insurance, and to allow insurers to again discriminate against people based on pre-existing conditions. That may be unfortunate, but at least California, New York, Massachusetts and Maryland won't be getting a disproportionate share of ACA spending.