HOUSTON—Texas led the court fight against health care reform, but health care policy experts say while the state was doing that, legislators did virtually nothing to prepare for the law.
"Now we have to realize that we gambled, and we lost, and we have to go forward from there and address the health care reform bill," Dr. Pauline Rosenau, a policy expert at the UT School of Public Health, said.
There is plenty to do, and there are huge stakes for everyone.
"Texas is way behind," UT’s Dr. Chuck Begley said.
Texas is the nation’s leader in uninsured people, with 6.2 million residents without coverage. That’s more than the entire population of Missouri.
"There is a strong incentive to figure this out and a short time to do it," said Dr. Begley.
Under the Affordable Health Care Act, Texas stands to gain more than $120 billion over 10 years in additional federal money to help expand the state-run Medicaid program.
However, in Texas recently, there is nothing simple about the state government accepting federal money. Governor Rick Perry has threatened more than once to turn down federal cash.
"We have to figure out if we can walk away from the federal dollars that are being offered as a result of Medicaid expansion," Begley said.
Texas also has done little to establish the insurance exchange that would make lower-priced coverage available here. If the state does not get that done by the first of the year, the federal government will step in and do it for Texas.
Critics say that Texas depended too much on the efforts of Texas Attorney General Greg Abbott, who has led the fight in the courts against what he calls Obamacare.
"What we are going to see is the battleground shift from the courthouse to the ballot box in November where Americans get to decide," Abbott said.
Abbott thinks a Mitt Romney presidential win would end with a repeal of the health care law.
But that includes a huge number of ifs. And without any bigger actions, some say it’s just another gamble.