In a statement published Monday morning, Texas Governor Rick Perry (R) "proudly" declared that he will decline to implement key tenets of the Affordable Care Act -- a move that will see his state forgo an estimated $164 billion dollars in federal aid and leave over 1.2 million low-income Texans, who would have finally been eligible for health care, helpless and uninsured.

"This is a fiscally stupid decision on the part of Rick Perry," Texas Democratic Party spokesperson Rebecca Acuña told Raw Story. "Texas would be one of the states that gets the most money from the federal government and the Medicaid expansion would have provided health care to more than a million Texans. It's... It's very sad that Rick Perry is willing to play politics with the health of Texans, and that's exactly what this decision is."

WATCH: Perry says Medicaid expansion like 'adding 1,000 people to the Titanic'

With his announcement, Perry becomes the sixth governor to refuse implementing a key aspect of the Affordable Care Act: the Medicaid expansion and the state-based health care exchanges. Republican governors in Florida, South Carolina, Mississippi, Louisiana and Wisconsin have made similar decisions, but Texas is by far the biggest.

Perry would seem to be inviting a political free-for-all thanks to the relative size and power of the Texas hospital industry, which absorbed more than $4.6 billion in unpaid emergency medical costs in 2010. While not seeing it as a cure-all, Texas hospitals largely praised the Affordable Care Act for dramatically expanding health care options for poor people, who are ultimately paid for by others who carry their own insurance. Nearly 25 percent of Texans -- 6.5 million people -- do not have health insurance, including more than 1.2 million children, and the state's health care system ranks last in the nation overall.

While citing some problems with the health reforms, the Texas Hospital Association praised the Supreme Court's decision to uphold the law, noting that it will see more than 4 million people across the state finally obtaining health insurance coverage. An additional 1.2 million still uninsured would have gotten health care through the Affordable Care Act's expansion of Medicaid, according to the Texas Health and Human Services Commission (PDF). That same commission predicted that expansion would send an estimated $164 billion tumbling into the Texas health care system between 2014 and 2023, spurring massive job creation and reducing the drag on working peoples' insurance premiums.

In a letter to Health and Human Services Director Kathleen Sebelius (PDF), Perry opined that giving poor people health care and setting up exchanges that make health insurance cheaper are both "brazen intrusions into the sovereignty of our state."

"I stand proudly with the growing chorus of governors who reject the [Affordable Care Act] power grab," Perry wrote. "Neither a 'state' exchange nor the expansion of Medicaid under the Orwellian-named PPACA would result in better 'patient protection' or in more 'affordable care.' What they would do is make Texas a mere appendage of the federal government when it comes to health care." He added that Medicaid is "broken" and "already financially unsustainable," and that in his view an expansion "would threaten even Texas with financial ruin."

"Rick Perry’s announcement is both cruel and negligent," the Texas Democratic Party retorted in a media advisory. "No person with a speck of intelligence would turn down billions in federal dollars that would be a boon to our economy and help Texans. But then again this is Rick Perry. Rick Perry could’ve brought billions in federal dollars to Texas, reduced the rate of the uninsured and improved the quality of life for Texans. Rick Perry’s Texas solution is to let Texans stay ill and uninsured. That is not a health care plan."

The state of Texas has the most restrictive Medicaid program in the country, requiring that a family of three make no more than $188 per month to qualify. Under federal rules administered by the Affordable Care Act, Medicaid would be expanded to 133 percent of the poverty level, covering an additional 1.2 million Texans under the program. That would cause a 46 percent increase in Medicaid enrollment which the Henry J. Kaiser Family Foundation (PDF) estimated would cost the state 3 percent more in 2019 than it currently pays, and the federal government would have picked up the rest.

A recent study of people on Medicaid in the state of Oregon found that the program boosted their health significantly, and that they were less likely to borrow money or be sent to collections agencies over medical bills.

Instead of implementing the Medicaid expansion and setting up a statewide exchange, Perry's decision will see the federal government implementing Texas's exchange instead, and leave millions without any care at all. Other significant portions of the Affordable Care Act will be put into place no matter what -- like requiring insurance providers to take people with preexisting conditions.

The Act also helps to close the "donut hole" in President George W. Bush's Medicare Part D plan by sending seniors rebates for their prescription costs; requires at least 80 percent of health care premium payments be spent on actual health care; lets young adults under 26 stay on their parents' health plans; provides contraception and birth control free of charge; eliminates lifetime coverage limits; restricts how quickly health insurance rates can be increased by private companies; and mandates that preventative care be covered for free.


Photo: Christopher Halloran /, all rights reserved.