What Would 'Perrycare' Look Like?

The Texas governor offered few specifics in his 2012 health platform, but a look at his record suggests he'd give states more control over federal programs

Rick Perry speaking in front of flag - Michael Thomas AP - banner.jpg

Gov. Rick Perry routinely attacks federal health care reform, calling it a massive overreach that intrudes into the lives of every American. But in the presidential contender's early days on the campaign trail, he has revealed little about what his own "Perrycare" could look like -- or how much changing American health care will figure into his candidacy.

Political strategists say, don't hold your breath: Republican candidates talk very little about health care in primary campaigns because the issue isn't a top priority for their voters, and because anything beyond hammering "Obamacare" could become a target for critics. They don't expect Perry to roll out details in stump speeches unless he makes it to the general election, where Democrats could try to hit him on Texas' low spending on mental health and Medicaid, and the state's poor rate of insurance coverage.

On Wednesday night, the governor's camp provided The Texas Tribune with an early sketch of what his health care plan could entail. Perry spokesman Mark Miner said the first thing the governor would do as president is work with Congress to repeal "Obamacare." Then he would "start over," first by working to stabilize the country's economy for employers, then by trying to "free states from federal mandates and empower them to develop innovative solutions." Finally, he would attempt to lower skyrocketing health care costs "through the proven, market-based strategies of transparency, choice and competition." Perry wants states to be given flexibility and incentives to foster competition in the insurance market, to design solutions for patients with pre-existing conditions, to lower costs for small businesses and to implement medical malpractice reform, Miner said.

Candidates on both sides of the aisle have a history of getting into trouble with voters when they unveil too much too soon. When it looked like Arizona Sen. John McCain's presidential bid might fold in 2007, the candidate produced highly detailed positions on policy issues, said Douglas Holtz-Eakin, president of the American Action Forum and one of McCain's top advisers in 2008. The result? "Barack Obama spent a lot of time shooting at our health care plan while saying nothing specific himself," Holtz-Eakin said.

Still, a look at Perry's legislative history provides signposts to what some of his specifics could be. In line with the general details released Wednesday, health care policy experts expect a President Perry would seek to allow more local control over the Food and Drug Administration to eliminate what he sees as road blocks preventing medical industries from taking off. And they think he'd shift far more responsibility for running Medicaid -- the joint state-federal health insurer that predominantly covers long-term care and poor children -- to the states, as evidenced by his requests for more flexibility (and control of the purse strings) from Washington.

At least on the campaign trail, Medicare would probably be excluded from that conversation, because talk of changing the federal health insurance program for the disabled and elderly could frighten seniors -- a key voting group, particularly in primaries. "He's going to have to use the bully pulpit to really explain how states have to take the leadership role and how people have to assume responsibility for themselves," said Arlene Wohlgemuth, executive director of the conservative Texas Public Policy Foundation, which has guided many of Perry's key legislative initiatives. "That's not going to be easy."

Presented by

Emily Ramshaw & Marilyn Werber Serafini

Emily Ramshaw is a reporter with The Texas Tribune. Marilyn Werber Serafini reports for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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