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Texas Governor Rick Perry Says Texas Will Not Expand Medicaid and Will Not Set Up State Run Health Insurance Exchange

By Brandon Moseley
Alabama Political Reporter

While the recent Supreme Court ruling that upheld the constitutionality of the Patient Protection And Affordable Care Act (PPACA) has been widely acclaimed as a victory for President Obama and his controversial takeover of the health care industry, there was one caveat to that ruling.  The Court ruled that Alabama, Florida, Texas, and the other state government plaintiffs can not be forced to participate in the program.  The President’s bill would have stripped states that refused to cooperate of federal Medicaid funds for children, expectant mothers, poor families, and indigent elderly.

Texas Governor Rick Perry became the 6th Governor to use that ruling to opt their state out of President Obama’s plans.  In a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius, the gun toting Texas Governor wrote:

“In the ObamaCare plan, the federal government sought to force the states to expand their Medicaid programs by * in the words of the Supreme Court – putting a gun to their heads. Now that the “gun to the head” has been removed, please relay this message to the President: I oppose both the expansion of Medicaid as provided in the Patient Protection and Affordable Care Act and the creation of a so-called “state” insurance exchange, because both represent brazen intrusions into the sovereignty of our state.

“I stand 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.”

“Neither a “state” exchange nor the expansion of Medicaid under the Orwellian-named PPACA would result in better “patient protection” or in more “affordable care.” What they would do is make Texas a mere appendage of the federal government when it comes to health care.”

“The PPACA does not truly allow states to create and operate their own exchanges. Instead, it gives the federal government the final say as to which insurance plans can operate in a so-called “state” exchange, what benefits those plans must provide, and what price controls and cost limits will apply. It leaves many questions to be answered later through federal “future rulemaking.””

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“In short, it essentially treats the states like subcontractors through which the federal government can control the insurance markets and pursue federal priorities rather than those of the individual states. Through its proposed expansion of Medicaid, the PPACA would simply enlarge a broken system that is already financially unsustainable. Medicaid is a system of inflexible mandates, one-size fits-all requirements, and wasteful, bureaucratic inefficiencies. Expanding it as the PPACA provides would only exacerbate the failure of the current system, and would threaten even Texas with financial ruin.”

“I look forward to implementing health care solutions that are right for the people of Texas.  I urge you to support me in that effort. In the meantime, the PPACA’s unsound encroachments will find no foothold here.”

Texas follows Florida, Wisconsin, South Carolina, Louisiana, and Mississippi in rejecting both the state exchanges and the Medicaid Expansion.  Expanding Medicaid would cost Alabama taxpayers over $500 million a year.  The current Medicaid system is costing the taxpayers $604 million a year.  Alabama voters will go to the polls on September 18th to decide if we should prop up Alabama Medicaid’s rising costs by raiding the Alabama Trust Fund of $250 million a year for the next three years.  Alabama Governor Robert Bentley is hopeful that the state will be able to fund the current Medicaid program with new sales taxes collected on internet purchases by then if the controversial diversion of trust fund principal dollars passes in September.  There is no current dedicated long term funding source for either a state of Alabama run insurance exchange or for the massive $5 billion expansion of the Alabama Medicaid program proposed by President Obama.

There is no word yet from Governor Bentley if the state will follow the path of other conservative governors and refuse to implement Obamacare in their states or not.

Brandon Moseley is a former reporter at the Alabama Political Reporter.



Expanding Medicaid is more than just adding job opportunities. This will literally save lives.


Alabama is one of 12 states that has chosen not to expand Medicaid.


Officials say the provisions in the bill would help about a million small business owners and employees as well as self-employed individuals.


Once the COVID public health emergency ends, millions will have to reapply for Medicaid or find coverage elsewhere.