The first rule of asking for extra federal dollars in Texas is to never make it seem like you are asking for extra federal dollars.
For Gov. Rick Perry, this is a tricky line to walk. Because as much as the Republican presidential candidate bashes the federal government in his campaign speeches, Texas gets a lot of money from the feds — and a lot of it is going to the health care system he insists Texas can handle on its own.
Perry has repeatedly decried the spending culture of Washington, railing against both President Barack Obama’s health care law and the federal stimulus. But as it happens, Texas has taken a lot of money from both.
More than $380 million in early grants and other aid from the federal health law have already gone to businesses and agencies in the Lone Star State, according to figures from the Department of Health and Human Services, and Texas ended up with $17 billion from the stimulus.
Now, the state is waiting for final approval of a new waiver from federal Medicaid rules that could allow the state to draw down an additional $12 billion in funds from the federal government.
And that’s before the main parts of the Affordable Care Act even kick in, bringing billions of dollars to Texas in extra Medicaid funds and subsidies to help people buy private coverage through a new health insurance exchange.
If the law survives its upcoming review by the Supreme Court, its expansion of Medicaid alone could cost the federal government anywhere from $53 billion to $67 billion in aid to Texas by 2019, according to estimates from the nonpartisan Henry J. Kaiser Family Foundation.
That’s more than any other state would get under that part of the law. The only other state that comes close is California, which would get between $45 billion and $55 billion in federal Medicaid funds.
“The only word that can describe this is hypocrisy,” said Democratic state Rep. Garnet Coleman. “These days, federal dollars might as well be counterfeit, they are so dirty — but Texas would not survive without them.”