Texas Gov. Rick Perry on Monday declared that his state would fight President Obama's health-care overhaul by refusing to expand Medicaid or set up one-stop insurance exchanges. Perry, a former GOP presidential candidate, called those ObamaCare provisions — the main pillars of the law — "brazen intrusions into the sovereignty of our state." He joined a growing group of outspoken Republican governors, including Rick Scott of Florida, Nikki Haley of South Carolina, and Bobby Jindal of Louisiana, who have vowed to resist the Affordable Care Act since the Supreme Court upheld it in late June. Will defying Obama's reform effort pay off? Here, four reasons the GOP governors might end up regretting wading into this fight:
1. Perry and other GOP governors are losing out on a windfall
Texas will lose out on $70 billion in federal money over six years if it opts out of the Medicaid expansion, according to Texas Well and Healthy, a coalition of ObamaCare supporters. "Our economy would benefit from this infusion, and our stretched health-care system needs the boost," Eileen Garcia, who participates in the coalition as chief executive of Texans Care for Children, tells The New York Times. Not only that, says Suzy Khimm at The Washington Post, but state and local governments have to shell out $10.5 billion for uncompensated care at hospitals each year, according to the Urban Institute. Expanding Medicaid would mean many of those bills for the uninsured would be covered, so it might "save states" that money.
2. Perry is giving the federal government more control in Texas
Perry is making it sound like he's keeping Washington out of Texas' business, says Charles P. Pierce at Esquire, but he's only going to "guarantee that the federal government takes over even more of it." Under the health-care law, the states are supposed to set up insurance exchanges to help people find the cheapest, best health coverage, but if state officials don't get the job done, the federal government will just step in and do it for them. Not to mention that adding a million-plus low-income Texans would give the state's Medicaid department leverage to bargain for concessions from Washington, says Emily Ramshaw at The Texas Tribune. The flip side, says Erika Johnsen at Hot Air, is that if Texas and the other "rebel states" fight hard enough, they might help Mitt Romney win the presidency and repeal ObamaCare entirely.
3. Hospitals and states will have to pay ER bills for the poor
Many hospitals are livid over the GOP governors' resistance to expanding Medicaid, says Jeffrey Young at The Huffington Post. They "currently treat the poor for free in emergency rooms," so they were banking on ObamaCare to "cut down on the number of unpaid bills on their books." The American Hospital Association and other industry groups endorsed ObamaCare, saying it would contribute $155 billion over a decade to cover uninsured patients. Perry and the other anti-ObamaCare GOP governors should brace themselves, says Jim Newell at Wonkette, because hospitals are going to "raise all sorts of hell" over this.
4. Republicans will own the broken health-care system
Democrats in Texas are having a field day with Perry's defiance. "Rick Perry's Texas solution is to let Texans stay ill and uninsured," Texas Democratic Party spokeswoman Rebecca Acuña said in a statement after the governor made his announcement. "That is not a health-care plan." To counter that line of attack, Republicans will have to advance "some other plan to care for the poor and sick," says Jonathan Chait at New York, and they don't have one. If they do come up with an alternative, it's certain to be as "expensive and unpopular" as Obama's plan, but by then it will be too late. The GOP will own America's diseased health-care system, and it will be up to them to fix it.
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