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Social Security and Medicare are Federal programs. If your state leaves the union, especially on the basis of supposed state sovereignty, it may well be that access to Federal programs is forfeited by the citizens of the new sovereign country.

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You can collect social security if you move out of the country. Medicare has different rules, as doctors have to opt into it.

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Under current law, yes. All congress would need to do - and there wouldn't be any TX legislators to stop this - is pass a new law that says payments would cease to anyone in secessionist states.

Hardball? Yes. Would it hurt innocent people who had nothing to do with secession? Again, yes. But any non-violent action should be on the table in such a scenario, and again, it may well be the quickest way to bring would-be secessionists to heel. It's like applying sanctions to a country like Russia. Of course the sanctions hurt the innocents more than the guilty, but it's done to hopefully goad the innocents into encouraging the guilty to change their ways.

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Even under current law, Medicare can pay for nothing outside the US.

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Yes and no. My mother had emergency surgery in a foreign country and Medicare covered it even without a previous authorization. I think it may have been because the total cost was a tenth of what it would have been in the US. However, you are correct that according to the CMS booklet Medicare does not cover medical services outside the US.

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