He is apparently trying to maximize the number of uninsured Texans.
Consider the case of Texas, which with 25 percent uninsured, leads the nation in not providing for its residents. If the state pulls out of Medicaid, as Gov. Rick Perry (R) is suggesting, that would put it at 40 percent uninsured, as Medicaid covers 15 percent of the state. Texas might try some other form of coverage, but it will have lost hundreds of millions of dollars of federal funding. You can occasionally do less with more, but when you have a lot less, you generally just do less. Whatever the state tried next would cover fewer people with less-comprehensive insurance, and it’s a safe bet that the rate of uninsured would ultimately settle above 30 percent. Some legacy.
Conversely, if Perry does nothing, the federal government is going to come in and pick up most of the cost of a massive coverage expansion. Texas, in fact, will be one of the biggest winners from health-care reform, as its huge pool of uninsured residents means the state will get an uncommonly large amount of subsidies to bring that down to manageable levels. Texas “can expect to see Medicaid enrollment rise by 46 percent while state spending on Medicaid rises by about 3 percent.” Pretty good deal.