Gov. Perry Tells Feds Texas Won't Expand Medicaid

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In response to Perry's letter, U.S. Department of Health and Human Services spokesman Keith Maley noted that consumers in all 50 states would have access to an exchange by 2014, and said the federal agency would ensure states have the "flexibility and resources they need" to implement the new law.

A Texas Medical Association survey given to The Associated Press over the weekend found that the number of Texas doctors willing to accept government-funded health insurance plans for the poor and the elderly has dropped dramatically amid complaints about low pay and red tape. Only 31 percent of Texas doctors said they were accepting new patients who rely on Medicaid. In 2010, the last time the survey was done, 42 percent of doctors were accepting new Medicaid patients. In 2000, that number was 67 percent.

Texas House Speaker Joe Straus, another Republican in the GOP-stronghold state, said he hoped voters would address the issue by electing Republican presidential candidate Mitt Romney, who has pledged to repeal the health care law. He would not say what he thought the state would do if Obama is re-elected.

"There are a lot of stakeholders we'd need to hear from before we could make a decision on that," Straus said.

Texas Democratic Party spokeswoman Rebecca Acuna called Perry's announcement "both cruel and negligent."

"Rick Perry's Texas solution is to let Texans stay ill and uninsured," Acuna said. "That is not a health care plan. Once again Perry is putting partisan political pandering in front of the interests of Texas."

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Associated Press writers Chris Tomlinson in Austin and Nomaan Merchant in Dallas contributed to this report.

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