HOUSTON (AP) -- If Texas wants to tailor its own expansion of health care coverage through the Affordable Care Act, then it's now up to state leaders to reach out to the federal government to have a dialogue, Health and Human Services Secretary Kathleen Sebelius said Monday.
During a visit to Houston promoting the implementation of the health care law with local leaders and community groups, Sebelius said the Obama Administration remains eager to have conversations with Texas about expanding health care coverage in the state. But, she said, key discussions about expanding Medicaid to provide health insurance to those who cannot afford it must first occur at the state level, not between Washington, D.C., and Texas.
She said conversations must take place between Texas legislators and leaders in the business, medical and faith communities to come up with a plan "that looks uniquely Texan."
"We are eager to have those conversations. But I think they need to start with a Texas group coming together and talking to us," she said while visiting a Houston health center and announcing the "Healthy Young America" video contest, which is aimed at showing young adults the benefits of the new health care law.
Open enrollment under the health care overhaul law begins Oct. 1. The act requires state-based health insurance exchanges, modeled on travel web sites, where people can compare and enroll in insurance plans. Coverage under these new insurance policies begins Jan. 1.
Republican leaders in Texas have refused to cooperate in the mandatory expansion of health care coverage, with the state not setting up its own insurance exchange and not expanding Medicaid to include those who cannot afford health insurance. Texas has the nation's highest rate of people without health insurance — about 6.1 million people — most of them the working poor and single adults.
"If Obamacare were sound health care policy, Secretary Sebelius wouldn't have to resort to video contests and prizes to tempt people to sign up. Texans are already subject to too much costly and burdensome federal regulation, and Obamacare only makes the problem worse," Gov. Rick Perry said in a statement.
Perry and other Republicans leaders have said the health care law infringes on personal liberty and violates state sovereignty.
Harris County Judge Ed Emmett, a Republican and one of the leaders Sebelius met with on Monday, said he believes it was a mistake for the state not to accept federal dollars to expand Medicaid.
"If we don't reimburse (uninsured or underinsured medical costs) through Medicaid, then the local taxpayer has to pick up that tab," he said.
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