FORT WORTH - Gov. Rick Perry on Thursday signed into law a Medicaid reform plan that aims to help as many as 200,000 more Texans get health insurance.

While Perry praised the bill with an insurance component that mainly targets workers earning too much to qualify for Medicaid, he said it was “not the magic wand.”

“We’ve still got unique challenges in this state,” Perry said before signing the bill. “We’ve still got some 5 million uninsured in this state, many of them who have immigrated from some pretty poor countries. But this plan is a good start.”

About one in four Texans - some 5.6 million people - are uninsured, the highest percentage in the nation.

One option is the three-share program, in which the state splits the cost of a health insurance premium with the worker and employer. Another is a committee that recommends incentives for companies to offer insurance. A third option establishes a funding pool setting aside part of federal uncompensated care money to connect low-income families with private health care.

U.S. Health and Human Services Secretary Mike Leavitt also attended the news conference at John Peter Smith Hospital, the county’s hospital.

“May I say, I think this is a profound step for Texas. This is a profound statement for America,” Leavitt said. “Every American needs to have access to an affordable basic insurance policy.”

Leavitt previously met with state lawmakers about the bill because many parts of it require federal waivers.

The bill, which takes effect Sept. 1, also encourages recipients to seek treatment at doctor’s office instead of the emergency room. It calls for instituting co-payments for treatment received in an ER if it can safely be delivered elsewhere.

It also rewards Texans for adopting healthy lifestyles, such as completing weight loss or stopping smoking programs.

State Sen. Jane Nelson, R-Lewisville, who sponsored the bill, said such reform was important because Medicaid costs have soared from 14 percent of the state budget a decade ago to 26 percent now.

“What we failed to do in the past was to attack these problems together rather than separately,” said Nelson, chair of the Senate Health and Human Services Committee. “Our goal with this bill was to treat this kind of as a three-legged stool: one leg being Medicaid, another being access to private insurance and another being healthy lifestyles.”

State Rep. Dianne White Delisi, R-Temple, who chairs the House Public Health Committee, called it watershed legislation that sent “a chill up my spine.”

Also as part of the bill, more women will qualify for the Medicaid Breast and Cervical Cancer Treatment Program. The bill also creates a customized benefit packages for children with special health-care needs.

The bill allows a needle exchange pilot project in San Antonio’s Bexar County. Texas is the only state that doesn’t allow such programs, which give users clean hypodermic needles and aim to curb the spread of diseases through intravenous drug use.

A bill allowing statewide needle exchange programs was passed by the Senate, but it died in the House.