Local officials in Texas are discussing whether to band together to expand Medicaid coverage in some of the state's biggest counties, making an end run around Gov. Rick Perry's opposition to the expanded program included in President Obama's healthcare law. For years, Texas's six most populous counties, as well as some smaller localities, have offered free or low-cost health care for uninsured residents with incomes as much as three times the federal poverty level, or about $57,000 for a family of three. The cost of the programs: about $2 billion a year.