Texas Gov. Rick Perry said Monday he will not implement ‘Obamacare’ provisions such as the Medicaid expansion and the insurance exchanges. The decision could mean that Texas ultimately loses an opportunity to cover half of its uninsured residents and relinquishes to the federal government more control over its health care system.
After informing the Obama administration of his intentions in a letter, Perry went on Fox News to explain his position. “If anyone had any doubt, we wanted to put it clearly to bed that Texas wasn’t going to be a part of expanding socializing of our medicine,” he said. “So we’re not going to participate in any exchanges. We’re not going to expand Medicaid.”
One in four Texans are uninsured, the highest rate of any state. The Medicaid expansion would cover 49.4 percent of uninsured Texans by 2019, according to the Kaiser Family Foundation. The program is broadened to cover Americans within 133 percent of the poverty line — currently the eligibility for a working Texan parent cuts off at 27 percent. The federal government will cover the full cost of the first three years and pay 90 percent thereafter.
Perry joins other GOP governors — including Florida’s Rick Scott, South Carolina’s Nikki Haley and Wisconsin’s Scott Walker — in refusing to implement the Affordable Care Act. The Supreme Court upheld the law but said the federal government may not cut off a state’s Medicaid funds if they turn down the expansion. If a state refuses to set up the insurance market exchanges, the federal government does it for them.
“I’m always intrigued with the concept that there’s free money out there,” Perry said. “We don’t trust this administration, and we don’t trust Washington, D.C. to be able to deliver health care in our states. If they trusted us, they would basically block grant it back to the states, and we would do a substantially better job than what you’re going to see with these exchanges and with the expansion of Medicaid.”
Internal Republican politics make it difficult for Perry and other governors to implement the Affordable Care Act even when it benefits their states. That political incentive is strong enough to compel cash-strapped governors to turn down money from Washington and give the federal government more control over their state’s health care system.
Perry, who ran a failed campaign for the Republican presidential nomination this cycle, chafed when asked on Fox what his decision means for the quarter of Texans who are uninsured.
“We’ve got some of the finest health care in the world,” he said. “So the idea that this federal government, which doesn’t like Texas to begin with, to pick and choose and come up with some data and say somehow Texas has the worst health care system in the world is just fake and false on its face.”
Sahil Kapur is a congressional reporter for TPM. He previously covered politics and public policy for numerous publications including The Guardian and The Huffington Post. He can be reached at sahil [at] talkingpointsmemo.com.