A In the ongoing battle over Medicaid in Texas, no one budged Monday.
As protesters marched outside Gov. Rick Perry's office, chanting and calling on leaders to accept federal dollars to expand the program and help more Texans, Perry -- flanked by fellow Republicans Lt. Gov. David Dewhurst, Texas Sens. John Cornyn and Ted Cruz, local U.S. Reps. Joe Barton and Michael Burgess and a handful of state lawmakers -- said that's not going to happen.
"Texas will not be held hostage by the Obama administration's attempt to force us into this fool's errand of adding more than a million Texans to a broken system," Perry said. "Medicaid expansion is, simply put, a misguided and ultimately doomed attempt to mask the shortcomings of Obamacare.
"In short, it's a prescription for failure, and Texas will not be part of it."
Some estimates show that expanding Medicaid under the federal Affordable Care Act could give coverage to another 1.5 million low-income Texans.
Democrats are urging top Republicans to reconsider expanding the program and accept nearly $80 billion over the next decade -- even though Texans might have to ultimately pay in about $9 million to help -- to do that.
"We know this can be done," said U.S. Rep. Joaquin Castro, D-San Antonio, who stood with local and statewide Democrats at a news conference Monday. "It's the right thing to do.
"I hope [Perry] will give up the swagger and get serious about expanding Medicaid in Texas."
Perry last month reached out to Texas' congressional delegation, asking for help to lock in "flexible federal funding" that would let Texas reform the current Medicaid program.
During a news conference Monday, which followed a roundtable discussion he held with local congressional leaders, protesters marched outside the governor's office, loudly chanting messages such as "Perry, take the money."
Over the noise, Perry said that even President Barack Obama has called the Medicaid system broken. He said Texans know "there is no such thing as free money" and expanding the program could hurt the state's economy, lead to tax increases and hurt the state's budget.
He and other Republicans say that from 1990 to 2010, national Medicaid costs increased 445 percent -- from $73.7 billion to $401.4 billion -- while the national Medicaid caseload increased by 135 percent, from 22.8 million to 53.6 million patients. They also say seven out of every 10 doctors in Texas will not accept new Medicaid patients.
"Medicaid is a broken system that is failing Texans and overwhelming the state budget," Cornyn said. "The program must be fundamentally reformed, and Texas -- not the federal government -- is best suited to design a healthcare program for its poorest and most vulnerable residents."
Perry said he wants the federal government to give Texas leaders flexibility to work on a separate program that would give participants some "skin in the game" -- health savings accounts, co-pays, deductibles and more control over their healthcare spending. He said the federal government should give the match to Texas in the form of a block grant.
"Instead of expanding an already broken system, it is imperative that we give states more flexibility than ever to run and reform the programs the best way they see fit," Barton said.
Burgess, an obstetrician, said the simple truth is that the federal government doesn't have the funds needed to uphold all its promises.
"I don't think the federal government is a reliable fiscal partner," he said.
Protesters marching around the Capitol on Monday say they hope Republican leaders will reconsider and accept the funding they say will bring $85 billion to the state over 10 years to help the economy.
W. Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council, was among those disappointed in Texas' top leaders' position Monday.
"The Affordable Care Act is not perfect, but it helps some of the most vulnerable in our society who hover near the federal poverty level," he said. "Many feel we cannot bear the cost of Medicaid expansion even though the first three years are fully funded, but there is a significant cost for not expanding Medicaid coverage."
Democrats said expanding the Medicaid program could impact the lives of Texans who now have no healthcare options available to them.
Castro, who led the Democrats' news conference with his brother, San Antonio Mayor Julian Castro, said expanding Medicaid could save countless dollars now being spent on uninsured Texans, who head to the hospital for care they can't afford.
"It's almost criminal that the governor will put petty partisan politics ahead of the basic economic interests of Texans," said state Rep. Lon Burnam, D-Fort Worth.
"We've tried Governor Perry's plan for 12 years, and after 12 years of Governor Perry's healthcare policies, we have the highest rate of uninsured in the nation with 6 million Texans without insurance," said state Rep. Chris Turner, D-Arlington, who also attended the event. "It's time for a new plan."
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