Then it's $4.32 per month more if your gaming session is like 4 hours of looping furmark. Nevertheless, my recommendation was for the OP in Bakersfield, CA, which is $0.14/kwh, I don't know how much he actually plays games so I just had to guess. Obviously if you're power is $23 per kw minute you might have to consider power draw.
I also love the bandwagon passion of people getting indignant about 120 watts of power for a $300 PURE LUXURY item. You think I'm living in the 19th century? Go power factor correct the inductive loads in your house, like your fridge and hvac blower motor, you'll probably save over 600 watts just from that. And turn the brightness down on your monitor. And quit buying luxury items like video cards and plastic.
Ahh perspective, you elusive lady.
As someone else said, CA has tiered rates and especially in the summer it can get brutal... 30+ cents/kWh.
Furthermore, I have said this over and over again on these forums, but idle power matters more than load power if you leave your PC on 24/7 or for much longer periods of time than you game. I crunched numbers recently and it's not a huge number, but it is recurring.. like $25-40 more than if you bought a 40nm card that offers equivalent performance in games, per year, every year, assuming 10 cents/kWh and a typical load profile w/ 80% efficient PSU.
Your other "point" is a false argument because you can easily buy a more power efficient card AND do all the other things you said. Or just not game at all or with with even lower-powered card, but I'm talking about efficiency purely, not conservation. It also takes very little effort to buy more efficient cards than to buy a new fridge, for instance.
Power draw also has additional effects such as possibly louder fans, and if you care, CO2 emissions and other pollutants from most power plants.
So yes power matters, especially to those who have high usage rates or high power rates or both. Like a car. If you drive a little, a cheap car may be a better option than a hybrid. But if you drive a lot, or if you pay $10/gal. for gasoline, or both, then a hybrid is probably more cost effective.
One size doesn't fit all. I think most people would agree with that.