Republicans frontrunner Rick Perry raised some eyebrows during Wednesday's GOP presidential debate by blaming the federal government for his state's staggering number of uninsured. As it turns out, those jaws were dropping with good reason. After all, just months ago Perry advocated opting out of the federal Medicaid partnership, a move which would cost up to 2.6 million Texans their health care coverage. And as it turns out, the Texas health care system Governor Perry called the best in the nation is actually ranked a dismal 46th.
As The Hill reported, Perry blamed Uncle Sam for the inconvenient truth that more than a quarter of residents in the Lone Star State have no health insurance:

"We've had a request in for years at Department of Health and Human Services 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," Perry said. "We know for a fact that, given that freedom, the states can do a better job at delivering that healthcare and you'd see more people -- not just in Texas, but across the country, have access to better healthcare."

It's a good thing Perry wasn't asked that question last November. Back then, he wanted Texas to drop out of Medicaid altogether and leave millions more without insurance.
With his cash-strapped state already leading the nation in the percentage of residents (30%) uninsured, last fall Governor Rick Perry floated the idea of opting out of Medicaid altogether. The idea of foregoing $15 billion in federal funds (60% of his state's Medicaid costs) went by the wayside when a study by the state Health and Human Services Commission found that "up to 2.6 million Texans could lose health coverage if the state opts out of Medicaid." Facing a massive $27 billion, two-year deficit due in part to reckless tax cuts and a refusal to raise revenue, Lone Star State Republicans were nevertheless looking at savaging its Medicaid program now serving 3.1 million people:

The total effect of the cuts -- estimated at $7.6 billion a year, or roughly a third of Texas' Medicaid spending -- will kill jobs, strain the state's economy and put people's lives at risk, experts across the state have said in recent weeks.

But Perry's debate night deception pales in comparison to his Texas-sized whopper from last July. That's when he agreed with radio host Bill Bennett that Texas has the best health care in America:

BENNETT: Thirty seconds on the doctors. You've got the best health care in the country, now I think, don't you? Because of your tort law?
PERRY: We do, yes. I spoke with the doctors yesterday in San Antonio. We've got, you know, three of the great health care -- well not -- three of the great health care regions. When you think about the medical center in Houston, there are more doctors, nurses, researchers go to work there than any other place in the world, every day. You got UT Southwestern up in University of Texas Health Sciences Center, San Antonio, Scott & White. I mean these fabulous health care facilities.

As it turns out, this isn't the first time Perry has made such grandiose claims about the Texas health care mess. In a Washington Post op-ed titled, "Let States Lead the Way," Perry and Newt Gingrich blasted Democratic health care reform proposals. The duo insisted it is the Lone Star State which should be at the front of that vanguard. In response, an incredulous Ezra Klein asked, "How's that working out?"
The answer, of course, is quite poorly. While from 2007 to 2009 Texas nudged its way from a horrific 48th to a merely miserable 46th in the Commonwealth Fund rankings, the health care system there remains an ongoing calamity for its residents. Among the poster children for the failure of red state health care, Perry's state brought up the rear across the five indicators measured. When it comes to health care access and equity, Texas is dead last.
While it is predictable that Republicans Bennett, Perry and Gingrich cite Texas' draconian tort reform law as an example for the nation, the data is far from clear as to its benefits in actually reducing malpractice premiums, lowering costs and attracting physicians to the underserved state.
As detailed in "Republican Malpractice Myths," it comes as no surprise that a cavalcade of GOP leaders, including Perry, Sarah Palin, John Cornyn and John Kyl cited the same study showing malpractice awards caps enacted in 2003 in Texas fueled an increase in the number of physicians in the Lone Star State:

According to the Pacific Research Institute, medical licenses in Texas have increased 18 percent in the last four years, with 7,000 new doctors moving to the state.

The actual impact of the Texas law, however, remains in dispute. The state's rising population, its 48th place ranking in physicians per capita, its staggering percentage of uninsured, its lack of an income tax and the 147% jump in malpractice premiums in 2003 alone make gauging the unique contribution of malpractice caps difficult to assess. Regardless, health care costs in Texas have continued their upward spiral. . (It's worth noting that Governor Haley Barbour's claim that tort reform meant that physicians in Mississippi "have quit leaving the state and limiting their practices to avoid lawsuit abuse" has similarly been debunked.)
Ultimately, Rick Perry's latest myth-making only serves to highlight the two inescapable truths of the debate over health care reform in the United States. First, health care is worst in precisely those reddest of states where Republicans poll best. Second, to get to the White House, Rick Perry will lie about that fact.