Gov. Rick Perry said Monday that Texas won't establish an online marketplace for patients to shop for insurance or expand Medicaid, two key elements of the federal health care overhaul.
In a letter sent to U.S. Health and Human Services Secretary Kathleen Sebelius, Perry said both elements "represent brazen intrusions into the sovereignty of our state."
"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 said in a statement.
The Supreme Court upheld most of the federal health care law last month, although it said the federal government can't withhold states' entire Medicaid allotment if they don't expand Medicaid, the health insurance program for the poor and disabled. If states choose not to set up a health care exchange, an online service for people to comparison shop for insurance, the federal government will establish one for them.
About 6.2 million Texans — a quarter of the state's population — are uninsured.
Expanding Medicaid would add millions of people "into the already unsustainable Medicaid program, at a potential cost of billions to Texas taxpayers," said Perry, a Republican. The Texas Health and Human Services Commission has estimated the Medicaid expansion would cost the state $27 billion in the first 10 years, a number many Democrats dispute.
The state has estimated about 2 million people would be added to the Texas Medicaid rolls in the first two years if it went ahead with the expansion.
Texas House Speaker Joe Straus, another Republican, said he hoped voters would address the issue by electing Republican presidential candidate Mitt Romney, who has promised to repeal the health care law. He would not say what he thought the state would do if President Barack Obama is re-elected.
"There are a lot of stakeholders we'd need to hear from before we could make a decision on that," Straus said.
Texas Medical Association survey given to The Associated Press over the weekend found that the number of Texas doctors willing to accept government-funded health insurance plans for the poor and the elderly has dropped dramatically amid complaints about low pay and red tape.
Only 31 percent of Texas doctors said they were accepting new patients who rely on Medicaid. In 2010, the last time the survey was done, 42 percent of doctors were accepting new Medicaid patients. In 2000, that number was 67 percent.
Texas Democratic Party spokeswoman Rebecca Acuna called Perry's announcement "both cruel and negligent."
"Rick Perry's Texas solution is to let Texans stay ill and uninsured," Acuna said. "That is not a health care plan. Once again Perry is putting partisan political pandering in front of the interests of Texas."
A message left seeking comment from Sebelius' office was not immediately returned Monday.
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