Attempting the hard sell, President Barack Obama hit Dallas Wednesday to visit leaders of the state with the highest rate of residents lacking health insurance coverage.

Obama planned to meet with Gov. Rick Perry, a former republican candidate for president, to discuss a key provision of the Affordable Care Act ["Obamacare"] — the expansion of the state-federal Medicaid program, which Texas has declined to join.

Preparing for the sales trip, White House communications and strategy advisor David Simas on Tuesday downplayed the summitry of a presidential meeting with one of Obamacare’s most vociferous opponents. “This isn’t a political issue,” he told Politico. “This is about making sure people where they live have access to good quality, affordable healthcare.”

The White House hopes Perry would consider joining a handful of Republican governors who’ve supported the expansion of Medicaid in their states, a program mostly funded by the federal government. Under federal healthcare law, states may choose whether to join the expansion.

Gov. Rick Perry Decries Federal Spending On Healthcare
Perry says Medicaid expansion would hurt America with a new, expensive entitlement. CC By 2.0

Thus far, the political battle over expanding Medicaid nearly overlays the much ballyhooed Red State/Blue State divide, with 25 states — and the District of Columbia — opting to join the expansion while 25 continue to decline. Meanwhile, several of the latter continue to consider expansion, with gubernatorial support.

In the ideological fight over state-based healthcare, Texas declined billions of dollars in federal funding for hospitals, providers, and other players in the gargantuan healthcare industry, while leaving some 4.2 million Texans uninsured. However, many Washington conservatives reject the economic argument favoring Obamacare’s Medicaid expansion.

“Expanding Medicaid is not the path to economic growth that anybody should want,” Joe Antos, a healthcare expert at the American Enterprise Institute, said in a statement. “It’s an inefficient way to create jobs. There a lot better ways to stimulate the economy.”

Yet, Simas and other White House officials insist resistance to Medicaid expansion comes from political obstinacy rather than economic expediency. Texas leaders, Simas said, should “put politics aside and not deny people healthcare out of ideology.”

To that end, the administration commissioned a study from a friendlier Beltway think-tank — the Rand Corporation — to study how states such as Texas would be affected by changes in healthcare law vis-à-vis political decisions. Their estimate shows Texans with private health insurance would pay 9.3 percent more than their present premiums should Texas continue to decline joining the Medicaid expansion, according to analyst Carter Price.

“Now you have a pool of people that their premiums are based not on how sick they are or how much healthcare they use, it’s simply based on age,” Price said. “When the pool of people are sicker, or you bring in more people that have higher expenses that’s going to raise everyone’s premiums in that pool.”

However, that 9.3 percent premium jump would affect only Texans purchasing private healthcare insurance not offered on the federal healthcare exchange, in which the state participates. As opposed to the Medicaid expansion, every state must offer residents the chance to purchase private health insurance on a government-run exchange, with federal subsidies for the poor — to fulfill the legal mandate to carry health insurance, upheld by the U.S. Supreme Court last year. Presently, 36 states participate in the federal healthcare exchange, with 14 states granted permission by Washington to operate their own.

With the implementation of the federal healthcare exchange, Texas’ uninsured population would fall from six million today to 4.2 million. Had the state opted to expand Medicaid, that figure would have dropped to 2.9 million uninsured residents.

In response to the Rand study, Perry accused the White House of a “desperate” effort to conceal problems with government-based health insurance. “The fact of the matter is, the administration is championing new federal regulations that will drive up the cost of health insurance on consumers across the state,” Perry said, in an effort to “shift the blame to the states that dare to oppose” Obamacare.

Those new federal regulations, in part, prohibit insurers from discriminating against Americans with pre-existing conditions, among other new requirements potentially driving the rise in many non-subsidized private policies sold independently of the government-run exchanges.

One in four Texans lacks health insurance.