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Governor Rick Perry (R-TX) linked to this instructional video produced by Texas State Rep.Lois Kolkhorst, the Republican chairwoman of the House Public Health Committee. In the video, Kolkhorst says Texas will benefit from exchange subsidies even though Texas has not created an Obamacare exchange. The law does not allow that.
Governor Perry's office posted the video March 28. Perry is to meet with Texas U.S. Senators Ted Cruz and John Cornyn to express continued opposition to expanding Medicaid under Obamacare. But Texas is apparently happy to take other federal deficit spending on health care, as long as it's not politically connected to President Obama.
The Texas Tribune quotes Kolkhorst as saying
her "journey this session has been to make an informed decision," and that she is not advocating for or against expanding Medicaid in the video. "There are some positives to not expanding Medicaid and there are some negatives, but for me, too much focus has been given to one part of the [Affordable Care Act]: Medicaid expansion."
But as Cato's Michael Cannon and Case-Western Reserve professor Jonathan Adler point out, subsidies are not available under the federal exchange. Accepting them will put Texas in the position of fighting for federal deficit spending not even the Nancy Pelosi Congress authorized.
Kolkhorst also touts Texas' plan to use a Medicaid "waiver" to provide Federally Qualified Health Clinics (FQHCs) around the state. A Medicaid waiver is essentially a grant to implement some temporary health program for the Medicaid population in lieu of regular Medicaid. Not only are those clinics literally socialized medicine, but after the federal deficit spending glut is over, Texans will be left to pay the bill.
It can be argued that the federal government should spend money to fund health care for the poor directly, on humanitarian and social infrastructure grounds. The constitutional grounds for that are shaky, however, and not the usual terra firma on which Texans prefer to build.
As Governor Perry said in rejecting the Obamacare exchange,
“If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare. I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government,” Perry says in the letter.
Kolkhorst, and perhaps Governor Perry, may be excited by the influx of federal money to Texas under Obamacare and Medicare waivers to fund socialized medicine, but they should know that they will be held to account for the deficit spending that funds them.