Fox News anchor Chris Wallace challenged Rick Perry over his claim that the federal government is responsible for Texas’ high number of uninsured during last night’s GOP presidential debate in Orlando, Florida, pointing out that Texas “has imposed some of the toughest eligibility rules for Medicaid of any state in the country” and ranks “49th in Medicaid coverage of low income residents.” Perry, who has said previously that Texas has the best health care system in the country, refused to take responsibility. He blamed the federal government for tying his hands and even insisted that people still come to Texas to take advantage of the state’s health care system:
PERRY: We’ve had a request in for the federal government so we could have a Medicaid waiver for years. The federal government has stopped us from having that medicaid waiver…that is how we go forward with our health care, each state deciding how they’re going to deliver that health care. Not one size fits all. [...]
The fact is, people continue to move to the state of Texas, some of the highest rates in the country because we’ve created a state where opportunity is very much the word of the day there, if you will, for finding work and what have you. Our health care is part of that. Our education is part of that. We are proud of what we put together in the state of Texas.
The fact of the matter is, Texas has has 16 Medicaid waivers, on par with other states its size and just last week received a thumbs up from the Obama administration “on a proposed overhaul of the Texas Medicaid program.” If the federal government grants its final approval, it will be Texas’ 17th Medicaid waiver. So the problem Texas faces isn’t one of flexibility — it’s the state’s unwillingness to expand its Medicaid program — despite escalating demand — the proliferation of low-income jobs and a relatively small rate of employer-based health care options — and a fairly high immigrant population. Meanwhile, eligibility rates remain narrow and Perry continues to undercut provider reimbursements, creating mass doctor shortages.
But of course, if Perry believes that the existing Medicaid program is hurting the state, he should be offering alternatives — something he has yet to do as a presidential candidate or governor. The fact of the matter is, for all the GOP’s talk of states as “laboratories of democracy” and innovation, the only state that has independently achieved universal coverage is Massachusetts (in a way in which Republicans loathe) and even it required additional federal assistance to implement its program.