Democratic state Sen. Leticia Van de Putte vowed to overturn Republican opposition to expanding the state’s Medicaid program under the Affordable Care Act if elected lieutenant governor, saying the state should act to protect poor, uninsured adults.

The San Antonio Democrat’s “Texas First Health Care Plan,” which she announced Friday at the Davila Pharmacy in San Antonio where she works as a pharmacist, attempts to close the coverage gap created when Texas lawmakers refused to expand Medicaid eligibility under the federal health reform law. She says expanding Medicaid is the “right choice” for the sky-high rate of uninsured Texans.

“As lieutenant governor, I’ll forge a Texas solution to draw down federal funds back to Texas taxpayers, protect Texas businesses, and expand access to affordable health care in our state,” Van de Putte said in a statement. “One out of every four Texans lacks health insurance. That system is unsustainable, bad for business, and bad for Texas families.

She contends that changing the state’s Medicaid program to insure poor adults — a feat that would require Republican support in the Legislature — could include cost-sharing between the state and beneficiaries, consisting of co-pays, income-based premiums on health plans, or using federal funds to purchase private insurance.

Most of the Legislature’s Republicans have staunchly opposed the federal health reform law and its optional Medicaid expansion provision, calling the joint federal-state insurer of poor children and the disabled a “broken system.” Gov. Rick Perry has gone as far as calling the Affordable Care Act’s Medicaid expansion provision “federal blackmailing.”

Had Texas expanded Medicaid to cover young adults, the federal government would have covered 100 percent of the cost for three years, eventually reducing its coverage to 90 percent. The federal government currently provides Texas with $60 in matching funds for every $40 the state spends on Medicaid services.

“Perhaps the most disappointing aspect of refusing this federal funding is that Texas taxpayers are left paying for the cost of treating those without insurance,” Van de Putte’s plan reads.

Her Republican opponent, state Sen. Dan Patrick of Houston, has steadfastly opposed the federal health reform law and expanding Medicaid. His spokesman, Alejandro Garcia, said Van de Putte’s health care proposal proves that she is “on the wrong side of the issues” because she has aligned herself with “failed policies.”

“Leticia Van de Putte continues to recklessly champion Obamacare, which has punished the business community and embarrassed the federal government since day one,” Garcia said, adding that Patrick would seek “flexibility and efficiency” within the existing Medicaid system in Texas.

Last year, lawmakers considered a few alternatives to Medicaid expansion, including a private market substitute and a proposal to request a block grant from the federal government to reform the current program.

While none received enough support to become law, the Legislature is likely to take up the issue again when it convenes in January.