Texas Gov. Rick Perry declared Monday that his state would not participate in the health law’s Medicaid expansion, becoming the sixth Republican governor to do so. If they follow through, these six states could singlehandedly shrink the insurance expansion by nearly 4 million people.
While the stakes are high for the White House, the territory is by no means uncharted. Washington has twice faced off with states over federal health care expansions, when Medicaid initially launched in 1965 and with the Children’s Health Insurance Program in 1997. Both times, all 50 states ultimately signed on â€" but not without some wrangling.
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