States thinking of withdrawing from the Medicaid program should think again, the head of the American Health Care Association says.

The state of Texas has become one of the foremost states in recent weeks threatening to opt out of federal Medicaid funding because of budget shortfalls and fears about the upcoming expansion of the program due to healthcare reform. Bruce Yarwood, president and CEO of the American Healthcare Association, warns that if Texas and other states follow through with the threats, the economic consequences could be devastating. In a letter to the editor of Kaiser Health News, Yarwood writes that local nursing facilities would be forced to close.

“Access to quality care would be decimated, facility job losses would be rampant, and already low state Medicaid rates could not possibly support the ongoing care needs of a rapidly aging population,” Yarwood said.

States and the federal government fund a total of 49 million low-income people on Medicaid. The new healthcare overhaul law is scheduled to add another 16 million beginning in 2014.