Texas governor Rick Perry suggested that he supports prohibiting insurers from denying coverage to individuals with pre-existing conditions during a town hall in Nashua, New Hampshire on Wednesday. Perry was in the midst of answering a question about what he would do to improve access to health care for the 50 million who are currently uninsured, when he said, “the pre-existing condition thing, I don’t have a problem with” and then suggested that “there may be a substantial number of those people that don’t want to spend their money for [health care coverage].” Watch it:

It’s unclear what form Perry’s policy would take, since he would repeal the Affordable Care Act and allow insurers to sell policies across state lines — something that would not be possible if people could wait to purchase coverage once they become sick. Several Republicans have proposed establishing state-based high-risk insurance pools for people who cannot buy coverage on the open market (the pools would require billions of dollars in federal funding in order to accommodate everyone who needs coverage).

“If you’re looking for someone who’s committed to health care and how to expand health care and how to make it more prevalent, I would suggest that you would look at what we’ve done over the last decade in the state of Texas,” Perry added. Unfortunately, the number of Texans without insurance has grown during Perry’s tenure and the state now has the highest uninsurance rates in the country.

Texas Gov. Rick Perry (R) has come under fire from his fellow GOP candidates for signing a mandate that required teenage girls to get HPV vaccines, despite his staunch public opposition to government interference in health care. The HPV mandate became even more damaging after it was revealed that Merck, the pharmaceutical company that manufactures the vaccine, was a major donor to Perry, and that a lobbyist who represented the company now heads a pro-Perry Super PAC that vowed to raise $55 million to support the governor’s presidential bid.

Now, the Center for Public Integrity reports on another troubling health care mandate Perry signed into law after receiving considerable funds from a pharmaceutical company that stands to benefit from it:

The 2009 measure, the Texas Heart Attack Prevention Bill, requires insurance companies to pay for CT scans and ultrasound tests that can detect heart disease. [...]

It was sponsored by a Democratic lawmaker who suffered from heart disease, and was promoted by a controversial medical group with a history of ties to Pfizer, which makes the cholesterol-lowering drug, Lipitor. Critics say Pfizer, a major Perry contributor, could benefit from the legislation because the mandated test would likely uncover more people with heart problems, who might then be prescribed Lipitor.

Perry received more money from Pfizer than any other political candidate nationwide over the past six years, campaign finance reports show. The company also contributed more than $2 million to the Republican Governors Association between 2006 and 2011, during which time Perry served two terms as the association’s chairman and also as finance chair.

Moreover, the measure was pushed by a group of what one prominent cardiologist called “shameless self-promoters,” several of whom also stood to benefit finally from the mandate.

But perhaps more troubling than the crony capitalism allegation is the fact that the mandate was “a terrible waste of health care dollars,” as one expert put it, at a time when state health budgets are strapped. “There is little evidence that the tests [Perry mandated] can improve people’s health,” experts said. Rather, they drive up health care costs by leading to unnecessary procedures and prescriptions. Many national health experts “sharply criticized” criticized the decision at the time, and have continued to rail against it since.

Perry claims to be against legislative intervention in health care, calling the Affordable Care Act an “unconstitutional and unsustainable government takeover,” but Texas has the most health insurance mandates than all but three other states. Even the conservative Texas Public Policy Foundation, which has advised Perry, has criticized the amount of requirements on health insurance providers in the state.

It’s telling that while Texas highest level of residents lacking heath insurance, Perry focused on this unnecessary mandate that will do little help outcomes but may helps donors.

As the super committee struggles to secure a deal ahead of its Nov. 23 deadline, Republicans have begun blaming Democrats for failing to conform to their spending and revenue requirements. This morning, committee co-chair Rep. Jeb Hensarling (R-TX) appeared on Fox News to fault Democrats for failing to embrace a Medicare reform plan that would partially privatize the program for future enrollees:

HENSARLING: Republicans have gone a great way in trying to negotiate here. We put forth a plan that would actually save and strengthen Medicare. They rejected our plan that was in our budget, so we said fine — if you don’t like that plan, how about something called Rivlin/Domenici, which is a bipartisan plan written principally by Bill Clinton’s former head of the Office of Management and Budget. We can negotiate around that. They rejected that too.

Watch it:

Switching one privatization plan for another is not much of a concession, particularly since the “compromise” plan would still force seniors to pay more for benefits and jeopardize one of the most efficient and popular health care programs in the country.

While the Medicare scheme contained in Paul Ryan’s budget would have forced tomorrow’s seniors to choose a private plan from an exchange of private plans and provided seniors with “premium support” that significantly depreciated over time, the “compromise” proposal preserves the existing fee-for-service Medicare program as an option and offers seniors a “premium support” that does more to keep up with actual health care spending. But seniors who choose to stay in the fee-for-service plan would still be stuck with a premium credit that did not keep up with health care spending and their costs would only increase as private plans cherry-pick the healthiest beneficiaries and leave sicker applicants to traditional Medicare. Ultimately, Rivlin/Domenici — like the Ryan plan before it — fails because it breaks up the market clout of traditional Medicare and sets the nation on an untested path of private competition that could do more to shift costs to seniors than limit overall health care spending. It moves the system closer to the Ryan ideal in which future Congresses could cut federal costs by eating away at the premium credit, thus pushing more health care costs on to the individual.

A better approach would be to take advantage of the bargaining clout of traditional Medicare and focus on modernizing the system through payment reform and delivery system changes, both those are precisely the kind of reforms that Republicans want to repeal in the Affordable Care Act.

In October, the health insurance industry released a report alleging that the Affordable Care Act’s taxes on health insurance plans will force companies to shift costs to consumers, adding up to “at least $73 billion in fees through 2019 and increase premiums between 2.8 and 3.7 percent in 2023.” Weeks later, Republican Sens. John Barrasso (WY) and Orrin Hatch (UT) publish an op-ed in Politico echoing this very same warning:

This is how it works: Starting in 2014, health insurance companies will be whacked with a tax based on their net premiums written in the fully insured market. Eighty-seven percent of small businesses purchase insurance in this fully insured market. It is also the place that the self-employed and uninsured go to purchase insurance.

So who will pay this tax? Ultimately, small businesses and their employees. It will most likely get passed through to employees — who will pay for it in lower wages or higher premium contributions. The average employee with a family plan will see take-home pay reduced by $5,000 over the next decade because of this tax, according to one study.

Set aside the hypocrisy of Republicans complaining about policies that pay for spending legislation — remember how they demanded that health care reform be fully paid for? — and what you have are two senators who are gulping down the industry’s kool-aid on premium increases. Both men count the insurers among their top campaign contributors, so it’s certainly no accident that they’re asking Congress to repeal taxes on an industry that’s earning record profits and is about to benefit from tens of millions of new customers as a result of the Affordable Care Act (ACA).

Of course, the appropriate response isn’t to roll back the taxes — which are necessary to finance reform and ensure that coverage expansion is fully paid for — but to strengthen provisions that help lower costs and mitigate the cost-shift. The ACA already requires insurers to spend 80 to 85 percent of their premium dollars on health care rather than administrative expenses and forces companies to justify proposed premium increases. And if the industry is now arguing that it doesn’t have the tools to control premium increases, then perhaps Barrasso and Hatch should bring back some of the cost control measures they helped defeat during the health reform debate. I’m looking at you, public option.

A new Gallup poll finds that while a plurality of Americans favor repeal — 47 percent to 42 percent — most still believe that it’s the “federal government’s responsibility to make sure all Americans have healthcare,” the same basic pattern found in 2009 and 2010. Fifty-six percent also told Gallup that “they prefer a system for providing healthcare based mostly on private health insurance, rather than one that is government run”:

So while Americans oppose a law called the Affordable Care Act, they support its provisions — the individual requirement and a private system of insurance (expressed in the ACA through state-based exchanges that will offer private coverage.) These elements remain popular despite two years of daily attacks and misrepresentations, which seemed to have only heightened the public’s frustration with the political process that created the ACA, while shielding the actual substance from too much disapproval. All this is good news for reform and suggests that it will only grow in popularity once a larger number of Americans benefit from it.

A recent CNN poll also found that “52% of Americans favor mandatory health insurance, up from 44% in June. [...] 47% oppose the health insurance mandate, down from 54% in early summer.”