Texas Gov. Rick Perry (R) doubled down Monday in his opposition to expanding Medicaid under President Obama's healthcare law, even though opposing it could cost his state $90 billion.
At a press conference where he was flanked by other conservatives, Perry argued expanding the health insurance program for the poor would make Texas “hostage” to the federal government.
States can choose whether or not to allow the federal expansion of Medicaid under the Supreme Court’s decision last year to uphold ObamaCare.
Allowing the expansion, in the case of Texas, would insure 1.5 million low-income Texans and bring $90 billion in federal funding to the state over the first decade, according to estimates.
Texas has the highest share of uninsured residents in the United States — about 29 percent of its adult population — and confronts billions of dollars worth of uncompensated hospital care every year.
That puts Perry in a tough spot.
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While his state could use the money, the conservative stalwart and former GOP presidential candidate has been vocally opposed to growing Medicaid, and doing an about-face now could damage his political brand.
Jay Root, a reporter for the Texas Tribune who wrote a book about Perry's last presidential run, said he could easily return as a presidential contender in coming years.
“The conventional wisdom in Austin is that he's not running for governor,” Root said. “If he's going to run for anything, he's going to run for president.”
Last month at the Conservative Political Action Conference, a venue known for hosting GOP presidential aspirants, Perry slammed the “unlimited role of government.”
“We care about our poorest Texans,” he said, turning to the Medicaid expansion.
“We want them to have the best care possible, and that cannot happen with a program that is on its way to bankruptcy.”
Perry was surrounded at Monday’s press conference by top Texas Republicans, including rising conservative star Sen. Ted Cruz.
Each leader slammed Medicaid, which is run jointly by federal and state officials, as an example of government ineptitude.
“Why in the world would we keep expanding this flawed system, and jamming more and more people into a program where they can’t find a doctor who will see them?” said Sen. John Cornyn (R-Texas).
Perry's staunch opposition to the Medicaid expansion stand in sharp contrast to other conservative GOP governors who have chosen to embrace the policy.
Jan Brewer (Ariz.), John Kasich (Ohio) and Rick Scott (Fla.) — all vocal critics of ObamaCare — have heeded calls from hospitals and advocates and chosen to back wider Medicaid eligibility.
But Perry said Monday that those leaders will “come to rue the day, because Medicaid will take a larger and larger share of their state budgets.”
Under the Affordable Care Act, states are encouraged to extend eligibility in their Medicaid programs to people living at or below 133 percent of the poverty line.
The law provides mostly federal funding for the expansion in order to entice states to accept it.
The heat surrounding the debate was evident Monday, as protesters who want Texas to expand Medicaid reportedly sought to shout Perry down during the press conference.
The group shouted "Perry, take the money!" and other slogans in support of the expansion, distracting attention from the Republicans' remarks.
This story was posted at 3:20 p.m. and updated at 6:10 p.m.