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The Brief: July 10, 2012

Texas has gained control of the latest political football to emerge from the U.S. Supreme Court's landmark health care ruling: Medicaid expansion.

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The Big Conversation:

Texas has gained control of the latest political football to emerge from the U.S. Supreme Court's landmark health care ruling: Medicaid expansion.

As the Tribune reported, Perry announced Monday that Texas will neither expand its Medicaid rolls nor establish a state health insurance exchange — key tenets of the federal health care law that the U.S. Supreme Court upheld last month.

The move makes Texas the largest state so far whose governor has rejected the Medicaid expansion. Though the high court ruled that the federal government may expand Medicaid to its liking, justices said the government may not penalize states if they choose not to accept the funding to do so.

The governor's office said he would work with the Legislature to block the provisions in Texas. "If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare," Perry said in a statement. "I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government."

Perry's critics pounced. "No person with a speck of intelligence would turn down billions in federal dollars that would be a boon to our economy and help Texans," said Texas Democratic Party spokeswoman Rebecca Acuña, adding, "Rick Perry’s Texas solution is to let Texans stay ill and uninsured. That is not a health care plan."

Perry's announcement came the same day that The Associated Press reported that the number of Texas doctors who say they're accepting new Medicaid patients has fallen to just 31 percent, down from 67 percent in 2000 — a dire statistic for a state that claims the highest uninsured rate in the nation.

According to The Dallas Morning News, Texas would spend $5.8 billion to fund the first five years of the Medicaid expansion but would receive $76.3 billion from the federal government. Still, Perry said accepting the terms of the expansion "would only make Texas a mere appendage of the federal government when it comes to health care," and in an interview with Fox News urged the feds to offer the money to states in block grants, which would allow more leeway in how the money is spent.

Texas lawmakers have also suggested that they might allow local hospital districts to try to negotiate with the federal government for their own communities if the expansion is blocked. Public hospitals currently face huge Medicaid funding cuts and, as the Morning News notes, stood to benefit greatly from the expansion.


  • Texas' long-awaited voter ID trial opened in Washington on Monday. Though the five-day trial — the first such voter ID case heard at a federal level this year — has drawn much attention, lawyers spent the first day largely rehashing old arguments. The U.S. Department of Justice, which opposes the law, and "defendant intervenors" like the NAACP made statements, and the state of Texas began calling witnesses, including state Rep. Jose Aliseda, R-Beeville. Today, the state is expected to finish calling witnesses.
  • After the state Senate's Republican Caucus released a letter on Sunday defending Lt. Gov.David Dewhurst against attacks from Ted Cruz, Cruz on Monday released his own "open letter," challenging Dewhurst to "honor your commitment to explain your record before Texas voters, not by hiding behind people who are not running for U.S. Senator, but by standing on your own two feet."
  • The state Senate’s Committee on Agricultural and Rural Affairs today will hear testimony on horse slaughtering, which was effectively outlawed in the U.S. more than five years ago but has re-emerged as an issue in Texas after the federal government lifted a ban on the practice last year. Though no new slaughterhouses have been proposed in Texas — which contained two of the country’s last three such facilities — some say the state's history with the industry has raised the possibility that Texas could soon lift its own ban on the practice.

"I’m not saying today that we need to cut $5 billion to straighten this out. What I am saying is that we should be honest in our budgeting. We should collect fees for their intended purpose or stop collecting them." — House Speaker Joe Straus on Monday in a speech on budget diversions


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