Gov. Rick Perry, in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, today confirmed that Texas has no intention of implementing a state insurance exchange or expanding Medicaid as part of Obamacare. Any state exchange must be approved by the Obama Administration and operate under specific federally mandated rules, many of which have yet to be established. Expanding Medicaid would mandate the admission of millions of additional Texans into the already unsustainable Medicaid program, at a potential cost of billions to Texas taxpayers.

"If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare," Gov. Perry said. "I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government.

"I stand proudly with the growing chorus of governors who reject the Obamacare power grab. Neither a "state" exchange nor the expansion of Medicaid under this program would result in better "patient protection" or in more "affordable care." They would only make Texas a mere appendage of the federal government when it comes to health care."

Gov. Perry has frequently called for the allocation of Medicaid funding in block grants so each state can tailor the program to specifically serve the needs of its unique challenges. As a common sense alternative, Gov. Perry has conveyed a vision to transform Medicaid into a system that reinforces individual responsibility, eliminates fragmentation and duplication, controls costs and focuses on quality health outcomes. This would include establishing reasonable benefits, personal accountability, and limits on services in Medicaid. It would also allow co-pays or cost sharing that apply to all Medicaid eligible groups - not just optional Medicaid populations - and tailor benefits to needs of the individual rather than a blanket entitlement.

Gov. Perry has consistently rejected federal funding when strings are attached that impose long-term financial burdens on Texans, or cede state control of state issues to the federal government. In 2009, Texas rejected Washington funding for the state's Unemployment Insurance program because it would have required the state to vastly expand the number of workers entitled to draw unemployment benefits, leading to higher UI taxes later.

In 2010, Gov. Perry declined "Race to the Top" dollars, which would have provided some up-front federal education funding if Texas disposed of state standards and adopted national standards and testing.

COLUMBIA, S.C. – Governor Nikki Haley today released a letter she wrote U.S. Sen. Jim DeMint regarding the Patient Protection and Affordable Care Act (ACA) and health exchanges in South Carolina. A copy of the governor’s letter to Sen. DeMint is attached.

In the wake of the Supreme Court’s ruling on the Patient Protection and Affordable Care Act, Sen. DeMint urged governors across the nation “to stop implementing the health care exchanges that would help implement the harmful effects of this misguided law. Americans have loudly rejected this federal takeover of health care, and governors should join with the people and reject its implementation.” (Press Release, Office of U.S. Senator Jim DeMint, 6/28/2012) Sen. DeMint also joined Members of Congress in writing a letter to governors regarding the Patient Protection and Affordable Care Act, asking them “to oppose its implementation” and “oppose any creation of a state health exchange mandated under the President’s discredited health care law.”

In her letter to Sen. DeMint, Gov. Haley wrote, “South Carolina stands with you and your cosigners in opposing implementation of state-based insurance exchanges – a decision we have been committed to since it was announced after careful consideration last December… Our analysis of the exchange law found that, among other things: states have little meaningful flexibility under the Obama administration’s concept of “state-based”; exchanges are required to assume many administrative functions now performed by the private insurance market; and most notably, the law’s primary intent is to create a new system for delivering federal insurance premium subsidies under rules governed by the Internal Revenue Service – a function where the state has no compelling role.
 
“Bottom line?  By refusing to implement state-based exchanges, the state is ceding nothing – we were given very little in the first place and, unsurprisingly, asked to give far too much in return. Critics of our decision sometimes forget that states are given a choice, and the law's authors may now wish that they had not written a federal exchange option into the law.  It is increasingly clear that without significant state assistance, it will be unlikely that any insurance exchange solution can be implemented at all.  With the implications of this choice in mind, combined with the Court’s decision properly returning Medicaid expansion decisions to the state and the fact that the “state-based” exchanges are state-based in name only, states opposed to ACA should not freely give up the leverage we now have to repeal and replace this bad law.”