Gov. Rick Perry says state Medicaid proposal has "languished" in federal file cabinet for years

It's no secret that Texas Gov. Rick Perry thinks states can do some things better than the federal government, including coordinating health care for its poorest residents.

In a Dec. 19 interview with Kathleen McKinley, whose blog appears on the Houston Chronicle's website, Perry said the state has good ideas for delivering care effectively. As an example, he pointed to a proposal that Texas submitted to the federal government with the goal of reducing the number of uninsured residents by "restructuring federal Medicaid funding." Medicaid uses federal and state funding to provide health insurance to low-income Americans.

Perry went on: "Unfortunately, this waiver, which presents a strategic alternative to continued reliance on government-run health care programs, has languished in a file cabinet at the Centers for Medicare and Medicaid Services for more than two years."

Perry's description of the waiver proposal's status rang a bell here at PolitiFact Texas. In the spring, we rated as False a statement Perry made in an April 15 interview with the Texas Tribune and Newsweek magazine that Texas has been waiting for more than two years for the federal government to act on a proposal to allow the state to "create insurance opportunities for those that are uninsured today."

We confirmed that Texas had sought permission from the U.S. Department of Health and Human Services in April 2008 to redirect Medicaid hospital funds into a state pool intended to help some low-income Texans get private insurance. However, in August 2008, during George W. Bush's presidency, an official with the Centers for Medicare and Medicaid Services, which is part of the federal health agency, sent a letter to the Texas Health and Human Services Commission stating that "a number of areas under this proposal have been identified as problematic" — making it impossible for the federal agency to approve the proposal as written.

Since then, state and federal officials have gone back and forth, without the state submitting a revised proposal and with no ultimate resolution. A federal official told us April 22 that the ball was in the state's court, saying that as of that time, the waiver request wasn't considered complete.

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Our story also quoted a state official saying that the proposal would probably need to be adjusted afresh to the just-approved federal overhaul of health care.

Eight months later, Perry appeared to be making the same claim, that the federal government — not the state — was responsible for the waiver request's stalled-out status. We wondered whether anything had changed since we last investigated this topic.

Not from the state's perspective. "We still consider the proposal to be pending," said Stephanie Goodman, a spokeswoman for the Texas health commission.

Not from the view of the federal government, which still considers the proposal incomplete. Mary Kahn, a spokeswoman for CMS, told us that the agency had "not yet received a revised proposal from the state." She declined to comment on Perry's statement that it's languishing in a file cabinet.

Perry's office did not respond to phone calls and e-mails seeking elaboration on the governor's recent characterization.

Summing up: Perry’s statement echoes a claim we rated False eight months ago. Significantly, the state has not revised its request to meet federal requirements, making this rerun worse than inaccurate. Pants on Fire!