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Texas Sidestep Exposes Medicaid Rhetoric

John Commins, for HealthLeaders Media, August 29, 2012

With that in mind, it was interesting to read a Washington Post article this week detailing the efforts of some Texas counties to do an end-run around Gov. Rick Perry's adamant opposition to the Medicaid expansion in the Patient Protection and Affordable Care Act. It provides a wonderful example of rhetoric crashing against reality.

The governor's rejection of Medicaid funding imperils billions of dollars for the state's healthcare infrastructure at a time of severe budget constraints for the state and local governments. By some estimates Texas would draw down $164 billion from the federal government over the first 10 years of the expansion, at a cost of $27 billion in state dollars.

Perry, an unsuccessful presidential contender, is one of at least six governors who have vowed to reject Medicaid expansion money. They are playing politics with an economic reality that goes beyond party affiliation and ideology.

In a July 9 letter to Health and Human Services Secretary Kathleen Sebelius, Perry said he stood "proudly with the growing chorus of governors who reject the PPACA power grab. Thank God and our nation's founders that we have the right to do so."

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