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“I just think the plan is a disaster on every level,” Patrick said. He doesn’t believe it will improve care or lower costs and instead will increase government spending and wait times for medical treatment.

Texas officials estimate it would cost the state $16 billion over 10 years to fully implement the law. The federal government would pay the full cost for the first three years. After that, the state share would be capped at 10 percent.

Andrea Gallegos said better health care coverage might have saved her husband’s life and been cheaper for the government, too.

“The thing is now they’re spending even more money because … we all ended up in the emergency room,” Gallegos said. “They’re wasting billions and billions of dollars just here in Texas.”

Gallegos recalls how Jose had his stomach removed and endured chemotherapy and radiation. He relied on donated medications, crossed the border for cheaper scans in Mexico and sometimes chose between doctors’ appointments when there wasn’t enough money. One month, while Jose was briefly in remission, he decided to see the cardiologist instead of going for a follow-up MRI.

Andrea wonders if missing that appointment was a “fatal mistake,” because the cancer came back. By the time they got the drugs donated for a new round of chemotherapy, it was too late.

Doctors initially gave Andrea three months to live, but she has fared better and got coverage through Planned Parenthood’s breast and cervical cancer program. Three years and two rounds of chemotherapy later, she frets about two sisters who also have cancer and no insurance. Neither has had any follow-up monitoring since her initial treatment.

Perry’s opposition to the Medicaid expansion has also drawn criticism from hospitals, which complain that they are forced to recover the cost of treating the uninsured by charging more to private insurance companies, which then pass the expense onto consumers as higher premiums.

Jim Valenti, president and CEO of University Medical Center of El Paso, sees it every day in his hospital, where nearly half of patients are uninsured. He hopes Perry reconsiders.

“In essence, the governor is saying no to as much as $112 billion in new federal Medicaid funds over the next ten years,” Valenti said. “Those funds will be directed to other states to cover their low-income residents.”

One of the hospital’s frequent visitors is Henry Austin, who suffers from HIV and epileptic seizures.

“My entire life is going from one doctor to another,” Austin said. Bill collectors “call all of the time, and I say: `I’m sorry, I don’t have any money. If I had, I’d give it to you.’”

Now health care executives must go back to the governor and lawmakers to figure out what comes next.

“If not Medicaid expansion, then what?” asked David Lopez, CEO of the Harris County Hospital District, where up to 80 percent of patients at some facilities are uninsured.

Ricardo Garcia, a 55-year-old from Alamo in South Texas, spent four years without insurance _ a period that included a second hernia surgery and a diabetes diagnosis. During that time, he bought less expensive medication in Mexico, sought treatment in emergency rooms, relied in part on donated insulin and worked out a payment plan with his surgeon.

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