The state of Texas is turning down billions of federal dollars that would have paid for health care coverage for 1.5 million poor Texans.
By refusing to participate in Medicaid expansion, which is part of the Affordable Care Act, the state will leave on the table an estimated $100 billion over the next decade.
Texas' share of the cost would have been just 7 percent of the total, but for Gov. Rick Perry and the state's Republican-dominated Legislature, even $1 in the name of "Obamacare" was a dollar too much.
"Texas will not be held hostage by the Obama administration's attempt to force us into this fool's errand of adding more than a million Texans to a broken system," Perry said.
Texas Republicans have moved steadily to the right — to where the very concept of public health insurance of any kind is looked at through narrowed eyes. Still, it's not easy to walk away from $100 billion from the federal government to help your state's poor, elderly and disabled, especially when you have powerful stakeholders like hospitals, doctors and cities clamoring for the state to take the money for their sakes.
Texas hospitals stand to lose about $7 billion.
"I don't think we will be OK, actually, especially when you consider the state cut us about $700 million a year in Medicaid payments because of the budget shortfall," says John Hawkins, a senior vice president at the Texas Hospital Association. "Now we're dealing with sequestration, which is another 2 percent.
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