Under Governor Rick Perry, the rate of Texans not covered by health insurance has gone up.
So the state still leads the nation for uninsured as it did when he became governor.
In his first debate, Perry blamed the federal government. But, that's not the response he has always given.
Perry loves to tout how Texas leads the nation in job creation.
It is also at the top, however, in the percentage of people without health insurance. But on that, Perry puts the blame elsewhere as he explained in last week's debate at the Reagan presidential library in California.
"Well, bottom line is that we would not have that many people uninsured in the state of Texas if you didn't have the federal government."
Perry asserted Medicaid, the federal/state health program for the low income Texans with minimum benefits, should be replaced with a block of money with no strings so states can craft their own programs for the uninsured.
"We know for a fact that given that freedom the states can do a better job to delivering health care and you'll see substantially more people, not just in Texas, but all across the country have access to better health care," said Perry.
That response appealed to conservative GOP voters and fits Perry's anti-Washington message.
Yet in mid-2009, before campaigns for re-election or even president, when asked why the state leads in uninsured. Perry did not mention the federal government. He said many young people just don't take insurance.
He cited Texas as a reason at a news conference on July 29, 2009.
"When you look at historically government programs Texas has not been one of those states that said we're going to be all things to all people and we're going to protect you from the cradle to the grave."
So, advocates for the low income said they worry now that Perry wants states to control how Medicaid is spent.
The rest of his 2009 answer indicated his outlook for Texas
"I think there is a culture in this state that basically says that from the standpoint of a state we're going to be a basically low benefits state when it comes to government programs," Perry concluded.
In a response to News 8, the Perry campaign didn't explain why he only blames the federal government now for Texas high rate of uninsured not mentioning the other factors.
It said they're not "mutually exclusive."
For now the political prognosis is the uninsured under Perry remains an issue for him.