Texas Gov. Rick Perry (R-TX) blamed the federal government for his state’s high uninsurance rate during last night’s presidential debate at the Ronald Reagan library, arguing that the Department of Health and Human Services has refused to grant Medicaid flexibility to the state:
HARRIS: Governor, quick follow-up. Why are so many people in Texas uninsured?
PERRY: Well, bottom line is that we would not have that many people uninsured in the state of Texas if you didn’t have the federal government. We’ve had requests in for years at the Health and Human Services agencies to have that type of flexibility where we could have menus, where we could have co-pays, and the federal government refuses to give us that flexibility.
We know for a fact that, given that freedom, the states can do a better job of delivering health care. And you’ll see substantially more people not just in Texas, but all across the country have access to better health care.
As much as Perry would like to shift the blame for his state’s high uninsurance rate — in fact, the number of uninsured has increased by approximately 2 million during his 11-year tenure — 26 percent of Texans don’t have access to health care coverage for four simple reasons: 1) many Texas jobs are low wage and don’t offer insurance, 2) Texas has some of the most restrictive Medicaid eligibility rules in the country, 3) insurance rates are largely unregulated (and are higher than the national average) and 4) the state has a large immigrant population that often can’t enroll because of legal concerns or other impediments. Perry himself hasn’t focused on the health care access problem during his governorship, despite advocating for significant reductions in the Medicaid program — including an 8 percent cut in reimbursement rates to hospitals in the latest state budget.
His requests for Medicaid “flexibility” from the federal government are unremarkable. As the Washington Post’s Sarah Kliff points out, aside from a failed 2008 waiver request to “limit the number of beneficiaries and create a new, very sparse benefits plan” — which was too restrictive even for the Bush administration — Perry doesn’t have much to show for his 11 years in office. Perry has failed to implement the policies he has espoused on the national stage (like “state innovation” in health care) and his health care record suggests that outside of some general conservative notions of limiting the reach of the Medicaid program to the very poor and reforming medical liability, he hasn’t emphasized health policy or even bothered to experiment with conservative solutions to expanding coverage and lowering costs. All that as his state is suffering from some of the highest uninsurance rates in the nation. Now what does that tell you about his priorities?