Although Governor Rick Perry said Texas would not expand Medicaid to implement the health care reform law nor set up a state insurance exchange, some counties in Texas want to expand the program. The counties are considering defying the governor. An excerpt:
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.
If some of the patients were enrolled in Medicaid, the state-federal health-care program for the poor, it could be salve for cash-strapped county budgets and a boon for local taxpayers….George Hernandez Jr., CEO of University Health System in San Antonio, came up with the idea of the alternative, county-run Medicaid expansion, and said he has been discussing it with other officials in his county, Bexar.
The U.S. Supreme Court upheld the law, but gave states the option to expand Medicaid. Counties that want to expand Medicaid on their own face at least two hurdles: the president and the state legislature.