The politics of the primaries have made toxic any consideration of once-conservative concepts like health insurance mandates and marketplace exchanges, because of their association with Mr. Obama?s plan. But in a different day and environment, Mr. Romney in Massachusetts and Mr. Huntsman in Utah embraced those very devices as state solutions, to differing degrees.
Mr. Perry, by contrast, eschewed direct efforts to expand coverage in Texas and cemented its status as the state with the highest rate of people without insurance.
When Mr. Perry succeeded George W. Bush in December 2000, about 22 percent of Texans had no insurance, second only to New Mexico. After Mr. Perry?s decade in office, Texas now claims the highest uninsured rate, at 26 percent, as well as other distinctions like the lowest rate of prenatal care.
Regardless, Mr. Perry has offered few initiatives to extend coverage. Instead, under the banner of state sovereignty, he has waged a running battle against the ballooning cost and structure of Medicaid, which covers more than a third of Texas children. At various points, Mr. Perry and the Republican-controlled Legislature have cut Medicaid benefits and provider reimbursement rates and made enrollment more onerous.
The three most prominent current or former governors running for president ? Rick Perry, Mitt Romney and Jon M. Huntsman Jr. ? are firmly united in their commitment to repealing President Obama?s health care law. But that unanimity masks a broad divergence in their approaches to the issue while in office, spanning the spectrum of Republican positioning.
The place of health care in the Republican primaries will necessarily be defined by Mr. Romney?s skill at neutralizing criticism of his landmark Massachusetts experiment and its paternity of ?Obamacare,? as opponents have dubbed the law. But each of the governors has vulnerabilities, and they have sought thus far to credential themselves less by their own past records than by their current opposition to what is officially known as the Affordable Care Act.
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I'll believe corporations are persons when Texas executes one.: LBJ's Ghost