Rick Perry on Health Care

Last Updated : Dec 13, 2011

Summary

In 1993, Rick Perry wrote a letter giving passive support to Hillary Clinton's efforts to reform health care in the United States through a system of mandates on employers. In 2001, he spoke in support of cross border insurance that would insure Mexican citizens living in the US.

Despite these efforts in support of government programs and increasing federal power, Governor Perry has supports state based solutions to health care while in office. He has opposed programs imposed by the federal government without state flexibility. With this in mind, Governor Perry supports the SCHIP program that matches state funds for children's insurance, and opposed the 2009-2010 health care reform efforts. He opposes a public option or single payer program.

Governor Perry started a program called TexCare to promote the SCHIP program. Enrollment peaked in May 2002 and was reduced due to a 2003 budget shortfall. A law was passed in 2003 that required enrollees to prove their continued eligibility every six months, as well as pass an assets test, and a 90-day waiting period before enrollment. These provisions were overturned in 2007. In 2010, one out of every three children in the state of Texas received their insurance through the SCHIP program.

The main efforts of Governor Perry in health care have been directed at establishing tort reform in Texas. He began these calls in 2002 seeking a cap to damages, special courts for malpractice, some immunities to providers that support low income areas, and some leeway for those previously denied malpractice coverage due to economic reasons. He stated that growing numbers of frivolous and abusive lawsuits, and escalating damage awards, settlements and legal expenses were partially to blame for skyrocketing health care costs.

Tort reform was accomplished in Texas in July of 2002. The reform consisted of a $250,000 cap on non-economic damages applied to all doctors in the case, a $250,000 cap on non-economic damages against a single institution and a $500,000 cap on all health-care institutions combined. Liability limits for hospitals that provide charity care were also included. The reform required a plaintiff to provide an expert witness report from a qualified physician within four months of filing suit, changed the Good Samaritan law to make it easier for a health care professional to provide emergency care to someone in need without fear of a lawsuit, and created a Medical Disclosure panel to draft a list of common risks which need to be disclosed to patients before they consent to a procedure.

After the passage of the tort reform legislation, Governor Perry stated that there is no greater threat posed to prosperity and growth than the triple threat of over-regulation, over-taxation and frivolous litigation. He predicted that the reform would bring prosperity to the state. When the nation was discussing health care reform in 2009, Governor Perry urged similar tort reform as an essential part to any health care reform. When discussing the ability of Texas to produce jobs during the 2009-2010 recession, Governor Perry cited tort reform as one reason jobs were being created in Texas.

Although vocally opposed to government invovlement in health care, in 2007 Governor Perry proposed a plan to provide subsidies to low-income individuals to purchase health insurance. He stated that this would be cheape in the long run as people would not use the emergency room as a primary care physician.

Governor Perry opposed the 2009 health care reform for numerous reasons. First, he stated that the program was an over-reach of federal government power into an arena which it did not have authority. He also opposed the one-size-fits-all approach which did not allow states to adjust to the realities of their populations as was done with the SCHIP program. He called for state specific solutions to the health care crisis and said that any successful solution would have different mechanisms for different states. Finally, he opposed the size of the program, the deficit spending, and the fancy accounting used to hide costs of the program.

In 2006, Texas was one of six states to participate in an Own Your Future program which encouraged those over 45 to be more active in planning for their long term health care plans. In 2007, Texas enacted Medicaid reform that established the Texas Health Opportunity Pool Trust Fund to provide premium subsidies to eligible Texans and help offset uncompensated care costs for providers who implement innovative measures to provide primary and preventive care, pilot programs such as positive incentives for healthy lifestyles, health savings accounts, and an incentive program to encourage regular health care visits, allowed individuals to opt out of Medicaid and use employer-sponsored insurance in some cases, encouraged the development and use of electronic health information standards and electronic health records to improve patient care, extended Medicaid coverage for former foster care children to age 23, if they are attending college, allowed cost sharing for non-emergency use of emergency rooms to support appropriate emergency room utilization, and used outcome-based performance measures and incentives in health maintenance organization contracts to increase access to appropriate health care services.

Governor Perry has proposed an initial health care plan that remains vague:

  1. Work with Congress to repeal “Obamacare”
  2. Stabilize the country’s economy for employers
  3. Lower skyrocketing health care costs “through the proven, market-based strategies of transparency, choice and competition”
  4. Implement Texas-style health care reform

 

HillaryCare

In 1993, Agricultural Commissionor Rick Perry sent a letter to First Lady Hillary Clinton stating that her health care plan to force employers to provide coverage for employees was worthy and commendable. The text of the letter is reproduced below with an image available here.

 

Bi-National Health Insurance

In August of 2001, Governor Perry gave a speech in Mexico to a border summit. In that speech, Governor Perry expressed his support for a proposed plan to provide bi-national health insurance.

 

SCHIP Announcement

In September of 2001, Governor Perry issued a press statement noting a speech made discussing the recent State Children Health Insurance Program (SCHIP).

In July of 2004, Governor Perry released a press statement noting both his support for the SCHIP program and his commitment to additional funds to provide benefits for those making up to 200% of the poverty level.

 

Texas and SCHIP

SCHIP was implemented in Texas in June 2000. It hit it's peak enrollment of 529,211 in May 2002. Due to a 2003 budget shortfall a law was passed that required enrollees to prove their continued eligibility every six months, as well as pass an assets test, and a 90-day waiting period before enrollment. This lowered enrollment. These provisions were overturned in 2007.

 

Call for Tort Reform

In April of 2002, Governor Perry issued a statement noting the harmful effect of extraneous lawsuits on health care in the US and Texas, and the need to reform the health care lawsuit system.

 

Expanding Health Care Options

In May of 2002, Governor Perry issued a press statement calling for more options for small businesses to buy health insurance. He called for allowing small businesses to buy insurance in high risk pools, and allowing insurance carriers to offer flexible health care plans that provide coverage for catastrophic needs at a lower cost.

 

Fulfillment of Tort Reform

In June of 2002, the state of Texas enacted tort reform legislation that placed a $250,000 cap on damages, required the plaintiff to have an expert witness, and required a list of common risks for all procedures.

 

Tort Reform will Spur Economy

In October of 2003, Governor Perry issued a press statement noting his views that the recent tort reforms enacted in Texas would help to spur the economy.

 

Own Your Future

In October of 2006, Governor Perry released a press statement noting the "Own Your Future" program. The program was to encourage people to save for their future health care costs in their senior years.

 

Healthier Texas

In February of 2007, Governor Texas proposed a new program for health care during the 2007 "State of the State" address. The program was called "Healthier Texas" and would have provided subsidies to low-income individuals to purchase health insurance.

 

Senate Bill 10 - Medicaid Reform

In June of 2007, the state legislature passed and Governor Perry signed Senate Bill 10 to reform portions of the state medicare program. Governor Perry issued a press statement noting his support for the legislation which accomplished the following reforms:

  • Establishing the Texas Health Opportunity Pool Trust Fund to provide premium subsidies to eligible Texans and help offset uncompensated care costs for providers who implement innovative measures to provide primary and preventive care.
  • Improving health outcomes and increasing consumer choice and responsibility through pilot programs such as positive incentives for healthy lifestyles, health savings accounts, and an incentive program to encourage regular health care visits.
  • Increasing employer-based insurance options through the Medicaid Health Insurance Premium Payment reimbursement program and allowing individuals to opt out of Medicaid and use employer-sponsored insurance in some cases.
  • Encouraging the development and use of electronic health information standards and electronic health records to improve patient care.
  • Extending Medicaid coverage for former foster care children to age 23, if they are attending college.
  • Using tailored benefits packages for children with special health care needs to better meet the complex needs of this population, reduce costs and simplify program administration.
  • Allowing cost sharing for non-emergency use of emergency rooms to support appropriate emergency room utilization.
  • Using outcome-based performance measures and incentives in health maintenance organization contracts to increase access to appropriate health care services.

 

Concern over Health Care Proposals - State's Rights

In early 2009, health care reform was a topic of discussion in Washington. Governor Perry responded to this discussion with concern that reform on a federal level could impede on the rights of states to determine the health care of the residents of that state. Governor Perry spoke often about this concern and appeared on the Mark Davis radio program in July of 2009.

As some of the proposed plans in Washington became public, concerns over state's rights became larger. Given the mandates that were present in the reform packages, there was a concern that the states may not be capable of paying for the services that the federal government was dictating that they must provide. On September 23, 2009 Governor Perry issued a press statement noting his belief that health care was a state right, that the propositions being considered by the federal government would impede on those rights, and that the mandates would be too costly to Texas.

Later in September, Governor Perry issued another press release noting that the solutions to health care should be accomplished at the state level. He stated that the mandates in the federal plan would cost Texas $60 Billion dollars over the next ten years. The press release echoed statements sent in a letter to Senate Finance Committee Chairman Max Baucus and the Texas Congressional Delegation. 

When the health care reform legislation passed through the House, Governor Perry sent a letter to other Governors asking them to join with Texas to stand up to unprecedented federal intrusion in health care.

 

The Public Option in Health Care

In late 2009, some federal legislators were discussing enacting a public option and allowing states to opt out. Governor Perry appeared on Fox Business and discussed his opposition to the plan in that states that opt out would still make you pay for it. He urges Americans to continue protesting the reform.

 

Reaction to Passage of Health Care Reform

In March of 2010, Governor Perry issued four press statements on health care reform. One asked the national representatives from Texas to vote no on the passage of what he called Obamacare, and the other three noted his opposition to the legislation and his plans to oppose it with a lawsuit. Two of those press statements and an editorial are highlighted below, noting Governor Perry's opposition to the reform and his plans to oppose it.

 

Response to Health Care Ruling

On October 14, 2010 Governor Perry responded to a ruling by a judge that challenges to the constitutionality of the 2009 health care reform legislation were valid by issuing a press release noting his opposition to the legislation.

 

Tort Reform

In August of 2009, Governor Perry wrote and editorial which noted that tort reform was passed in Texas in 2003. He stated that the effects of this reform in Texas have been a greater presence of doctors, a greater availability of health care, and a lower overall cost. He urges the US Congress to consider tort reform when developing plans. In that same month, he released a press statement noting that tort reform was essential to any health care reform on a national level.

 

State Solutions

In September of 2009, Governor Perry released a press statement noting the need for state specific solutions in the health care debate.

 

High Risk Pools

In April of 2010, Governor Perry issued a press statement noting his decision that the State of Texas could not commit to operating a new temporary high-risk pool program due to the lack of program rules or reliable federal funding.

 

Initial Health Care Plan

On August 25, 2011 Governor Perry proposed an initial health care plan to the Texas Tribune. The plan was non-specific and entailed four key items:

  1. Work with Congress to repeal “Obamacare”
  2. Stabilize the country’s economy for employers
  3. Lower skyrocketing health care costs “through the proven, market-based strategies of transparency, choice and competition”
  4. Implement Texas-style health care reform

 

TEA Party Debate

In September of 2011, Governor Perry participated in the TEA party debate. He was asked about the prescription drugs benefit known as Medicare Part D and stated that he would not push to repeal the program.

 

 

Michigan Economic Debate

In November of 2011, Governor Perry participated in the Michigan economic debate. He discussed his support for returning Medicare and Medicare to the states.

 

Campaign Website Statements

 

 

2012 Health Care Plan

 

References

[1] Website: Texas Public Policy Foundation Article: CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) Author: Kalese Hammonds Accessed on: 07/27/2011

[2] Website: Houston Chronicle Article: Perry letter commending Hillary Clinton found Author: R.G. RATCLIFFE Accessed on: 09/04/2011

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