Gov. Rick Perry's decision for Texas to opt out of healthcare expansion could have as much as a $90 million impact every year on revenues at Longview's Good Shepherd Medical Center, according to the hospital's chief. Ed Banos, president and CEO of Good Shepherd, on Tuesday said the decision by Perry to reject much of the Affordable Care Act’s expansion of Medicare and Medicaid could be devastating to hospitals such as his, which serve a large number of uninsured and people covered by those government programs.