Texas will not expand Medicaid or implement a state health exchange following the Supreme Court's upholding of the constitutionality of Obamacare, Gov. Rick Perry (R) said Monday.
"If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare, I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government," Perry said in a statement Monday. He sent a letter to Health and Human Services Secretary Kathleen Sebelius announcing his opposition to the law.
Perry joins a growing list of GOP governors who say they won't implement the two provisions, including Nikki Haley of South Carolina, Scott Walker of Wisconsin, Rick Scott of Florida and Bobby Jindal of Louisiana.
The federal government, however, will implement the health insurance exchanges for the states if they don't do so.
The Supreme Court upheld the individual mandate, but struck down the penalty in the law for states to lose their Medicaid funding if they do not participate in the expansion, which covers those with incomes up to 133 percent of the poverty line.
The Medicaid expansion would reduce the number of uninsured in Texas. The state has the highest rate of uninsured in the country, at 25 percent, or 6.2 million people. It also has the worst health care services and delivery in the nation according to the federal Agency for Health Care Research and Quality. A Kaiser Family Foundation report estimated that by 2019, Texas' Medicaid rolls would increase by 45 percent -- almost 1.4 million people who previously did not have insurance -- and state spending would only increase by 3 percent from baseline. The federal government would pay for 95 percent of the costs from 2014-2019.
Medicaid, however, remains an imperfect solution to medical care -- fewer doctors want to take its reimbursement rates, which Texas doctors say covers about half of their costs. Only 31 percent of doctors are taking new patients with Medicaid, according to the Texas Medical Association. Making matters worse, the GOP-controlled legislature cut reimbursements by 2 percent in 2010 and 2011.
Here is the letter that Perry sent to Sebelius:
This post has been updated to include Perry's letter.
At the CNBC debate on November 9, Perry <a href="http://www.huffingtonpost.com/2011/11/10/rick-perry-oops-video_n_1085336.html" target="_hplink">famously forgot</a> one of the government agencies he would eliminate if elected: <blockquote>"It's three government agencies when I get there that are gone: Commerce, Education and the um, what's the third one there. Let's see," Perry said. He turned to Texas Rep. Ron Paul, looking for some help, but got nothing but a remark from Paul that he would eliminate five agencies. "Oh five," Perry said. "So Commerce, Education, and, uh, the uh, um, um." "EPA?" offered former Massachusetts Gov. Mitt Romney. "EPA, there ya go," Perry said as the room exploded in laughter. CNBC moderator John Harwood honed in and pressed Perry: "Seriously? Is EPA the one you were talking about?" "No sir. No sir. We were talking about the, um, agencies of government," Perry said. "The EPA needs to be rebuilt." "But you can't name the third one?" Harwood persisted. "The third agency of government," Perry said. "I would do away with the education, the um, Commerce, and let's see. I can't think of the third one. I can't. Sorry. Oops."</blockquote>
Voting Age Flub
<a href="http://www.huffingtonpost.com/2011/11/29/rick-perry-gets-voting-ag_n_1119126.html" target="_hplink">During a campaign stop</a> at Saint Anselm College in New Hampshire, Perry got both the voting age and the date of the 2012 presidential election wrong. "Those of you that will be 21 by November the 12th, I ask for your support and your vote," he said to the students. The legal voting age has been 18 since the 26th Amendment was adopted in 1971. The general election is scheduled for November 6, 2012.
New Hampshire... Caucus?
During a November <a href="http://www.huffingtonpost.com/2011/11/30/rick-perry-new-hampshire-caucus_n_1120304.html" target="_hplink">interview </a>with Fox News, Perry mistakenly referred to the New Hampshire "caucuses." When asked about the emergence of front runners Mitt Romney and Newt Gingrich, Perry responded, "Americans haven't decided yet at all who they want to lead the Republican nomination, and we're going to be talking about that and we're going to be talking about it in harsh and strong terms over the course of the next four to five weeks as we get ready for those New Hampshire caucuses." New Hampshire holds primaries, not caucuses.
Minimum Age To Run For President
While speaking to Catcher Jones, a seven-year-old from Greenville, South Carolina in December, Perry flubbed the minimum age to run for president. "I'm glad you're not 21," Perry told Jones, who was wearing a t-shirt that said "Future President: Accepting Campaign Donations Now." Perry realized his mistake and added, "Or actually 35."
War With Iran
After a woman in South Carolina asked Perry what he thought about current United States military operations, Perry mistakenly started talking about the wars in Afghanistan and Iran. When an audience member alerted Perry to his error, he joked that his comment "will be on the front page."
Following a debate in New Hampshire, Perry met with fraternity brothers at Dartmouth College. When someone asked him about the issue of states' rights, Perry said that one of the "reasons we fought the revolution in the 16th century was to get away from that kind of onerous crown." The Revolutionary War occurred in the 18th century.
<a href="http://www.youtube.com/watch?feature=player_embedded&v=OMK7La2721Y" target="_hplink">In an interview</a> with CNN last year, Perry got stuck in a time warp. "Washington has abused the Constitution. You go back to the, a decade ago, with Woodrow Wilson..." Wilson was president from 1913 to 1921.
Bizarre Campaign Speech
In October, <a href="http://www.huffingtonpost.com/2011/10/29/video-rick-perrys-unusual-speech-performance_n_1065571.html" target="_hplink">an unusual performance</a> at a speech in Manchester led many to question the candidate's sobriety. Perry later made a statement to dispel rumors that he was drinking or using painkillers during the speech.
Bush Was Good At "Defending Us From Freedom"
During an interview with the <em>Today Show</em> last November, Perry told host Meredith Viera that "Bush did an incredible job, in the presidency, defending us from freedom."
While speaking with the editorial board of the <em>Des Moines Register</em>, <a href="http://www.huffingtonpost.com/2011/12/09/rick-perry-gaffe-sonia-sotomayor_n_1139541.html?1323463939" target="_hplink">Perry struggled</a> to remember Supreme Court Justice Sonia Sotomayor's name: <blockquote>"Do you really think he [President Barack Obama] is waging a war on religion?" asked an editorial board member, referring to Perry's recent ad pledging to "end Obama's war on religion" and "fight against liberal attacks on our religious heritage" as president. "I do because when you see his appointment of two -- from my perspective, inarguably -- activist judges, whether it was," he said, then trailing off for about six seconds trying to recall her name. "Montomayor," he said. Someone on the editorial board said Sotomayor's name. "Sotomayor and [Elena] Kagan, who are both activist judges," he continued.</blockquote>