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Texas Gov. Perry Wants Block Grant to Reform Medicaid without Expanding

In a letter to the state's health agency on Monday, the governor laid out his plan to request a federal waiver to reform Medicaid as Texas sees fit — without expanding eligibility.

In a letter to the state's health agency on Monday, the governor laid out his plan to request a federal waiver to reform Medicaid as Texas sees fit — without expanding eligibility.

“Seemingly, the president and his administration are content to simply throw money at a problem and hope that any problems will resolve themselves,” Perry wrote in a Monday letter to Kyle Janek, the executive commissioner of Texas' Health and Human Services Commission. “My response, and the response of the Texas Legislature, has been crystal clear: Texas will not expand Medicaid under Obamacare.”

Instead, Perry has asked that the agency request flexibility in the form of a block grant — a fixed amount of money, rather than matching dollars for Medicaid services — from the federal government to fundamentally reform Medicaid. Specifically, Perry requested that the agency seek a waiver that allows the state to make changes to the program without receiving federal approval, continue asset and resource testing to determine eligibility, and initiate cost-sharing initiatives, such as co-payments, premiums and deductibles, among other reforms.

Caroline Cournoyer is GOVERNING's senior web editor.