As Governor Rick Perry (R-TX) takes a strong lead in the race for the Republican presidential nomination his record is coming under closer scrutiny. Perry’s detractors often point to the high number of uninsured in the state. Texas leads the country with 27.2% of its population uninsured. In comparison Massachusetts, which passed a law mandating health care coverage similar to “ObamaCare,” has just 5.2% of its population uninsured. When pressed on this fact in last night’s debate Perry blamed the federal government for Texas uninsured problem. However, Perry’s critics might point out the numerous federal health care programs which keep even more of the Texas from being uninsured.
Medicare alone covers 2.37 million Texans. Medicaid covers another 3.3 million. Without even including hospital coverage for veterans that is 5.6 million Texans who would be without coverage if not for the federal government. The Texas population is currently 24.78 million, meaning the uninsured population would be well over 40% in Texas without these federal programs.
But Perry claims that the federal government is not allowing him to have the “flexibility” to cover more patients. As Think Progress points out, Perry’s request were not to expand Medicaid coverage within the state but to further restrict coverage. Perry wanted to strictly limit who would qualify for Medicaid and greatly lessen the benefits provided by Medicaid. In the end Perry’s plan was even rejected by the Bush administration as too harsh.
Texas has also provided less funding than most other states to match the federal dollars provided through Medicaid. This year alone Texas cut the Medicaid reimbursements rates by 1%, making many doctors consider dropping the program altogether. When Texas pays less in reimbursements to providers it discourages doctors and hospitals from offering coverage to the poor and disabled. As a result of Texas low tax rate and low spending rates on health care over the past 11 years of Perry’s governorship the state’s uninsured population has grown by 2 million.
Ezra Klein of The Washington Post details the real reasons behind Texas’ high uninsured rate. Texas has a largely unregulated health care insurance market. Rather than expanding coverage with the “magic hand” of the free market, the lack of regulation has caused insurers to raise rates on those customers that are likely to cost them the most, effectively pricing those consumers out of coverage. In addition, many of the new jobs created in Texas are low-wage, low-benefit positions which do not offer health insurance.
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