Rick Perry and Bernie Madoff

When confronted by a reporter with the fact that over half the working people in Hidalgo and Cameron Counties in the Lower Valley have no health insurance, Gov. Rick Perry’s response was to claim that health care reform legislation would “bankrupt this state.”

State Senator Eliot Shapleigh (D-El Paso) nailed it when he retorted, “Rick Perry advising on health care is like Bernie Madoff advising on family savings.”

Perry claims the reform legislation would add $3 to $6 billion dollars in mandated charges to the state budget, mostly to cover increased Medicaid eligibility. Medicaid has always been a shared federal/state responsibility. It seems that secessionist-leaning, states’ rights advocate Gov. Perry finds this particular state responsibility not to his liking.

Fair enough. One can debate the wisdom of having the states pay for such a large share of Medicaid. But where has Perry been over his three terms as governor? “In those 10 years, he kicked over 230,000 kids out of CHIP, 500,000 kids out of Medicaid, sent nearly $1 billion in Texas CHIP money back to D.C., presided over 91.6% increase in health care premiums and led Texas to dead last in citizens who have health insurance,” Shapleigh pointed out.

We know where Shapleigh stands, and those of us who see the need for health care reform to be the leading civil rights issue of our age are fortunate to have him representing us.

The people of Brownsville and San Benito are not so lucky, as their State Senator and two Representatives sat silent through Perry’s remarks and failed to challenge them afterwards.

We have every reason to believe that the five State Representatives from El Paso County – Joe Pickett, Chente Quintanilla, Norma Chavez, Joe Moody, and Marisa Marquez – will not be equally silent. To varying degrees, they’ve come down on the progressive side of issues like health care, social services, and civil rights. As the election season nears, though, we need to be sure that meaningful health care reform is near the top of their agendas.

Why is this a state issue? To be sure, all the focus has been on the legislation being crafted at the federal level. But eventually, a bill will be passed, hopefully by the end of the year, and then the states will be involved for sure.

First, there will be considerable obligations passed on to the states, with budgetary consequences as Perry correctly points out. More importantly, the bill will almost surely fall well short of stemming the hemorrhage in health care suffered by the 1 in 4 Texans who lack insurance, and the much larger number who are abused, limited, or underfunded by their health insurance policies.

I previously proposed a cost-effective system of state run clinics for outpatient, pediatric, and postnatal care that would provide a safety net for the underinsured. Other ideas are badly needed and worth considering. No one has a monopoly on the single best solution. But sitting silent and doing nothing is not an option at the federal level this year, nor will it be at the state level in 2011.