Last week, while states like Florida and South Carolina were stating their intentions to opt out of the portion of the Affordable Care Act that expands Medicaid coverage to millions of Americans, Texas — where approximately 2 million currently uninsured residents would have been eligible for coverage. remained oddly quiet on the matter. That is, until Governor Rick Perry declared his intention this morning.

“If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare,” wrote Perry in a statement released Monday. “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.”

The ACA had originally compelled states to participate in Medicaid expansion by penalizing those states that opted out. In June, the U.S. Supreme Court struck down the penalty as unconstitutional, but said the federal government could offer incentives for participation.

Medicaid expansion, which would increase the number of Americans eligible for coverage by making it available to anyone with incomes up to 133% of the poverty line. It is scheduled to begin in 2014, with the feds paying all the costs through 2016. Between 2016 and 2022, the state contribution is slated to ramp up to 7% of the total cost (approximately $73 billion over the six years).

Opponents say the states can’t afford any additional costs being added to their Medicaid tabs, while supporters of Medicaid expansion argue that states are only going to end up paying more as the number of uninsured Americans grows.

“States will face the reality that they will be giving up millions or billions of federal dollars and still end up with hundreds or thousands of uninsured people who will drive up health care costs for everyone else,” explains DeAnn Friedholm, Consumers Union’s Campaign Director of Health Care Reform.

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