As the leaders of Texas government gather in Austin, Rice University political scientist Mark Jones offers a fundamental fact.
"Rick Perry has health insurance as do all 180 members of the Texas legislature right now," Jones said.
Trouble is one out of four of the citizens they serve have no health coverage, the worst rate in the entire nation.
With passage of President Barack Obama's Affordable Care Act and the expansion of Medicaid prescribed by the plan Texas was given, the opportunity to provide medical insurance to more than one million previously unprotected people.
Seth Chandler and Pat Gray, a former Texas lawmaker, have crunched the numbers at the University of Houston Law Center.
"For a relatively small net amount of money, we can insure an awful lot of Texans and send Washington the bill," Chandler said.
"I don't see realistically where we can afford to walk away from this," Gray said.
But the governor of Texas says no.
"We're not going to expand Medicaid. We are just not going to participate in the socialization of health care in Texas," Perry said in July 2012.
But what he and conservative backers can't deny is that every federal Medicaid dollar Texas rejects will be re-directed to folks who are not so choosy.
"You are going to be sending money to New York to California to Vermont to other states to help their uninsured," Chandler said.
"We are, in essence, funding the expansion of Medicaid in other states while at the same time denying Texans access to health care," Jones said in agreement.
What's worse: a large chunk of that re-directed money originated right here in with the federal taxes paid by Texans.
"We pay more to the federal government than we get back so if we don't take advantage of this, we are leaving that money to go to other states," Gray said.
Meantime, the cost of caring for those too poor to pay for their own coverage remains with local communities.
"There's really no free lunch. When people are medically uninsured, somebody is paying for their care, often through the most expensive services, through emergency rooms, through inpatient care, through sadly, the jails," said Steven Schnee, Executive Director of MHMRA of Harris County.
And so to Texas lawmakers who want nothing to do with "Obamacare", Chandler suggests a rapid reassessment for the greater good of those they serve.
"You lost, so take advantage of the parts of the bill that will actually help people," said Chandler.
Experts estimate Texas would lose as much $100 billion in federal Medicaid funds over 10 years if it refuses to expand benefits to the uninsured.