This morning, in a move about as surprising as the sun rising, Governor Rick Perry came out with guns blazing against the Affordable Health Care Act, recently approved (mostly) by the U.S. Supreme Court.
The act's expanded Medicaid coverage for the poor will not be implemented in Perry's state, despite the fact that Texas ranked dead last in the federal government's report on healthcare services and delivery. And he says he'll also nix the health insurance exchange, another major tenet of the legislation.
"Neither a 'state' exchange nor the expansion of Medicaid under this program would result in better 'patient protection' or in more 'affordable care.' They would only make Texas a mere appendage of the federal government when it comes to health care," Perry said in a strongly worded letter to Kathleen Sebelius, the secretary of the Department of Health and Human Services.
He included a request that she relay a message to President Obama:
"I oppose both the expansion of Medicaid as provided in the Patient Protection and Affordable Care Act and the creation of a so-called 'state' insurance exchange, because both represent brazen intrusions into the sovereignty of our state."
Perry shares his sentiments with a growing list of governors including Nikki Haley of South Carolina, Scott Walker of Wisconsin, Rick Scott of Florida and Bobby Jindal of Louisiana.
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Expanding the "broken system" of Medicaid, Perry writes, will "exacerbate the failure of the current system, and would threaten even Texas with financial ruin." (Implied: If it will threaten Texas with financial ruin, everywhere else will be ruined three-fold.)
Not included in Perry's letter is that Texas is the "uninsured capital of the United States," as worded by the Texas Medical Association. More than six million Texans lack insurance, including more than a million children -- a rate that's almost twice the national average. While no one would argue that Medicaid is a perfect system, Obamacare would provide coverage to more Texans. Further complicating the discussion, The Associated Press reported yesterday that fewer Texas doctors are accepting Medicaid patients, because they are not fully reimbursed for the care they provide.
Under the current underfunded public healthcare system, doctors take the hit alongside the government. So to expand that could make it difficult for those insured by government programs to find adequate care and could create a more widespread system of doctors who aren't compensated for the services they provide or an increasing number of doctors who refuse to offer services to Medicaid patients.
So, the situation here in Texas isn't ideal, to put it very mildly. But is the answer telling the federal government to shove it, at the expense of those who most need the expanded care? In Texas -- yes.