Gov. Rick Perry (R-TX) may have solidified his reputation with small-government conservatives when he described Social Security, Medicare, and Medicaid as “a Ponzi scheme” that he would consider opting out of, but he also tarnished his credibility by accepting additional federal funding for the program. In 2009 and then again in 2010 Perry publicly complained about the “strings attached” to some of the federal dollars, but ultimately took — even requested — the money. From the Texas’ Health and Human Services Commission website:
— SEPTEMBER 2009: The Center for Medicaid & Medicare Services (CMS) has notified HHSC that Texas qualified for Tier II FMAP reimbursement starting in July 2009. This allows the state to draw a higher federal match for Medicaid expenses. The Tier II federal match rate is 69.85 percent for Texas, up from the Tier I rate of 68.76 percent.
— JANUARY 2010: Texas Qualifies for Tier III Medicaid Match The Center for Medicaid & Medicare Services (CMS) notified HHSC that Texas qualified for Tier III FMAP reimbursement starting in October 2009. This adjustment is based on recent unemployment data and allows the state to draw a higher federal match for Medicaid expenses. The Tier III federal match rate is 70.94 percent for Texas, up from the Tier II rate of 69.85 percent.
— OCTOBER 2010: The ARRA FMAP was set to expire on December 31, 2010 but has been extended for six-months at phased-down rates. The phased-down state fiscal year 2011 FMAP rates are 68.11 percent from January 2011 through March 2011 and 66.23 percent from April 2011 through June 2011. With the FMAP extension, the average state fiscal year 2011 FMAP is 67.33 percent.
The original stimulus package included $87 billion in enhanced federal Medicaid funding, which meant that the federal government had increased its contribution to state Medicaid programs by 6.2 percentage points through December 31, 2010. In August, at the request of 42 governors, Obama signed a 6-month phase-out extension of that increase through June 2011.
Perry was one of eight Republican governors who didn’t publicly lobby for the additional dollars in February of 2010, but asked the federal government for the extra funds once they became available. A Perry spokesperson explained that Texans “paid their share of taxes and should get some of that money back” — which is the same argument that Democrats used to dissuade the governor from opting out of the program entirely.
In early 2011, however, Perry also spearheaded a state effort asking the federal government to allow the states to Medicaid “as they see fit” — finding savings by curbing mandatory benefits or limiting eligibility among Medicaid populations.