Throughout the recent legislative session, Gov. Rick Perry held the position that Texas would not participate in the expansion of Medicare.
The governor stood firm on that, despite offers from the Health and Human Services Secretary to create a “uniquely Texas” approach to its implementation.
Perry’s stance had state Democrats pleading with the governor to change his mind.
“I was extremely disappointed, primarily because I think it was the right thing to do, and secondarily because we had come up with a compromise that seemed workable, that had strong bipartisan support, that had majority support, that could have passed," Democratic Rep. Donna Howard said.
Instead, lawmakers made it a requirement they had to approve any expansion of Medicaid eligibility, so unless they're called back for a special session, they'll have to wait until 2015 to give consent to expanding coverage to poor adults.
"We will have missed a huge chunk of the federal dollars, but it's not over," Howard said.
Under the Affordable Care Act, the federal government has committed $90 billion to extend health benefits to adults below the federal poverty line through Texas' Medicaid program.
If the state chose to expand, the federal government would pick up the tab for the new enrollees for the first three years. After that, the state would be required to pay a portion of those benefits.
"So people would say, '45 billion and four billion? Take the money.' I don't believe, and many of us don't believe, that that money's going to be there," Republic Rep. Larry Gonzalez said.
Gonzales says Medicaid's a broken system so why push more people into it? He fears the federal government won't hold up its end of the bargain and will leave the state more in debt in the future.
"With this administration and there's just no confidence going forward that this is going to operate any differently,” he said.
Those in favor of the expansion say it could have provided up to one million Texans some health coverage.
Money from the federal government has come to Texas healthcare providers in the way of what are called 'navigator' grants. They’re to educate staff on how to help people enroll in the federal exchange.