The Brief: June 29, 2012

The Big Conversation:

Texas' political leadership took the big news hard, but the next step for the state — implementing federal health care reform in its entirety — may be even harder.

In one of its most significant decisions in decades, the U.S. Supreme Court on Thursday upheld President Barack Obama's federal health care overhaul, including the law's so-called individual mandate, dealing a major blow to Texas, one of 26 states that sued to block the law.

Democrats celebrated the survival of Obama's signature legislative achievement, but some of the state's top Republicans called the news a "shocking disappointment," a "disaster for America" and a "sad day for liberty." One, congressional candidate and former Texas Secretary of State Roger Williams, said he was "ENORMOUSLY DISGUSTED." (All-caps his.)

But as the Tribune's Emily Ramshaw and Shefali Luthra report, what's next for Texas after the political dust settles remains unclear.

One of the two major issues the state must face deals with Medicaid, the insurer for children, the disabled and the very poor. The federal law dramatically expands Medicaid, which the state has already struggled mightily to finance, but the court ruled that the federal government may not withhold Medicaid money from states that reject the expansion and the accompanying federal financing.

Attorney General Greg Abbott said it remained unclear whether Texas would opt out, but Tom Suehs, the head of the state's Health and Human Services Commission, in a statement praised the court for giving states "more ability to push back" against the Medicaid provision. Texas officials, after all, have been unafraid to reject federal dollars for programs they've fought against.

The other matter the state must now confront: the establishment of a state health insurance exchange, which would allow Texans to compare and purchase coverage. Under the health care law, the federal government will impose a one-size-fits all program in states that fail to set up their own exchanges.

Texas officials have so far mostly resisted efforts to set up the exchange. Republicans last session blocked the blueprint for an exchange developed by a member of their own party, and legislators don't meet again for another six months, presenting the state with a challenge as the preliminary deadline of Jan. 1, 2013, approaches.

The ruling, though, may spur state officials to act. Kandice Sanaie, a governmental affairs manager at the Texas Association of Business, said the state could rely on an agency or executive order to develop the exchange. State health officials have also indicated that they've been working quietly to prepare the state in case the law was upheld.

Culled:

• U.S. Senate candidate Ted Cruz on Thursday clashed with state Sen. Dan Patrick, R-Houston, on Patrick's Houston-based radio show. In a heated exchange, Patrick accused Cruz of running a negative campaign and incorrectly blaming Lt. Gov. David Dewhurst for the failure of some conservative legislation. Cruz shot back by accusing Patrick, who has said he won't endorse in the race, of quietly working for the Dewhurst campaign. "Every time I go on the radio, you ask the question that the Dewhurst campaign wants you to ask, and then you’re interview is put in their ads," Cruz said. "You’re an effective surrogate. You defend him far better than he does." The Dewhurst campaign later posted the exchange online, calling it a "train wreck" and an "epic meltdown."

• Eight Texas cities appear on a list of the 15 fastest-growing large American cities released Thursday by the U.S. Census Bureau. Though New Orleans claimed the top spot, Round Rock, Austin, Plano, McKinney, Frisco and Denton filled out the next six spots, with McAllen and Carrollton placing 13th and 14th.

• U.S. Rep. Sheila Jackson Lee of Houston on Thursday walked out of the Capitol with fellow members of the Congressional Black Caucus to protest the Republican-led vote to hold Attorney General Eric Holder in contempt over his involvement in the "Fast and Furious" weapons scandal. "The fact that [the vote] occurred in such as speedy timeframe is evidence that we are engaging not in helping improve the lives of the American public but in political aggrandizing and wasting time with an abuse of power," Jackson Lee told the Houston Chronicle. Led by the Black Caucus, more than 100 Democrats participated in the walkout, which included the House Hispanic, Asian-Pacific and Progressive caucuses, as well as Minority Leader Nancy Pelosi.

"Do you want me to respond, or do you want to just yell at me?" — Ted Cruz to state Sen. Dan Patrick in an appearance on Patrick's radio show Thursday

Must-Read:

• The truth about the Fast and Furious scandal, Fortune
• Proud Mary, Dallas Voice
• Early reports on health-care decision from CNN, Fox overturned one mandate: Accuracy, The Washington Post
• On Most Major Issues, Cruz and Dewhurst Agree, The Texas Tribune