DALLAS - Governor Rick Perry said Monday Texas will not implement two portions of President Obama's health care plan that would effect millions of uninsured Texans, health care providers and employers.
Perry said the state won't establish an online marketplace for patients to shop for insurance, or expand Medicaid.
Under last month's Supreme Court decision, states can choose whether to expand Medicaid, the state-federal program to assist the poor with health care.
According to the Center for Public Policy Priorities, an Austin think tank that studies low- and middle-income issues, that expansion in Texas would newly enroll some 1.5 million adults and nearly 600,000 children.
Under the law, here's the ten-year plan: The federal government would pay for 100 percent of the expansion for three years. The federal government would pay 90 percent after that. That will come out to $112 billion in federal money.
According to the state, that extra 10 percent would cost Texas $9.5 billion over ten years.
Perry's decision involves policy, but also with some politics mixed in. And Democrats say Perry may not have the final word.
Since Perry limped back to Texas in January following his failed presidential campaign, he's sought to reclaim the stage in Texas with an eye to also stay in the national picture. This decision gave him the chance to prominently stand on both.
Perry, in a mid-morning appearance on Fox News Channel, said expanding Medicaid in Texas would be too much government and too much cost.
"Medicaid is a failed program," he said on Fox News. "To expand this program is not unlike adding a thousand people to the Titanic."
Perry claims expanding Medicaid would not result in better care for the poor, despite a federal report just last week that found Texas last in the nation for the delivery of health care. More than six million Texas residents don't have insurance, which is the highest in the nation.
Perry scoffed at the report.
"To pick and choose, and come up with some data and say somehow Texas has you know the worst health care system in the world is just fake and false on its face," Perry said.
Democrats say Perry's decision means Texas taxpayers would subsidize care for the poor in other states, while left with the costs locally, such as at county hospitals.
Houston State Rep. Garnet Coleman is one of the leading Democratic voices in the legislature.
"Governor Perry is going to have to lead at some point, instead of just saying 'no' to things he doesn't like," Coleman told WFAA. "A statesman stands up for the people of their state."
Perry prefers the government give Texas a block grant, so the state could run its own program. But Perry doesn't have the final word.
A statement from the Texas Senate Democratic Caucus said, "Today’s announcement was utterly lacking in transparency, debate or discussion. This is a decision for the people of Texas and their representatives, not a dictate to be handed down from on high in Austin. And the Texas Constitution ensures that this will not be the last word on the matter."
It would be a long shot, but Coleman said lawmakers could stick all Medicaid funding, including expansion, into an appropriations bill and dare Perry to veto it.
"But there is a way to have the expansion occur without the governor signing on to it," Coleman said.
Republicans will likely still control the legislature in January, and if Perry follows his recent pattern, he will lean more on lawmakers to fall in line with his thinking, which is that expanding Medicaid would be "socializing health care and bankrupting" the state.
Perry does give signs of still relishing the national spotlight, explaining his decision not to Texas media, but on Fox with rhetoric ringing from his presidential campaign.
"[We're] going in direct conflict with our founding fathers wishes, and freedom for that matter," Perry said. "People need to be free to make those decisions about their health care."
Regarding a health insurance exchange where Texans can buy competitively priced insurance, Perry said the state won't set one up because, "We don't know what these exchanges are going to look like," he said.
"There's still a substantial amount of wording in this legislation that I'm pretty sure Congress is just now reading for the first time," he continued.
But the federal government gave the Texas Department of Insurance one million dollars in 2010 to study how to set one up, but the department ended up sending back $900,000 of it.
A Republican-backed bill was filed in the Texas House last year to set up an exchange, but it went nowhere under Perry's veto threat.
"But I'm sure that under federal direction that the exchange will work fine," Coleman said. "I promise that I'll work with the federal government to make sure that there's a Texas flavor to this exchange."