RUTHFULLY YOURS

The attempt to dismiss the Texas jobs record seems to have abated, at least for now, but the episode shouldn’t pass without mentioning the other great liberal theme: More than a quarter of the Lone Star State’s people lack health insurance, and supposedly this is proof that Governor Rick Perry hates the poor, as well as vindicating President Obama’s health-care plan.

On top of Democratic criticism, we wouldn’t be surprised if Mitt Romney uses the issue to attack Mr. Perry as the former Massachusetts Governor fights for the GOP Presidential nod. The contrasts are instructive, but the factoid that 26.3% of Texans under age 65 are uninsured—compared to the national rate of 17.2%—could use a little scrutiny.

The main complaint seems to be that Mr. Perry is responsible because he has declined to expand Medicaid beyond its original purpose of a last resort for poor women and children. Yet some 17% of the Texas population is enrolled in Medicaid, compared to the national average of 19%. The number of Texans on Medicaid increased 78% between 1999 and 2009, with another big boost recently amid the recession.

It’s easy to reduce the uninsured rate if government simply covers everyone—as in Massachusetts, where four out of five of the newly insured since Mr. Romney’s 2006 reform now receive low- or no-cost public coverage. This coverage is straining the Bay State’s budget enough that its government is now moving to impose price controls on all medical care. Texas also could have expanded entitlements the way that other states have done, like California where 29% are on Medicaid, or New York at 26%.

The point is that there are trade-offs between prosperity and entitlement government. The Texas economy is growing and adding jobs in part because it hasn’t adopted the economic model that Mr. Obama favors: high tax rates on the upper middle class, lots of politically directed investment, heavy unionization and a dominant government role in health care. We suspect most voters would prefer the growth that drives jobs and raises incomes over higher taxes to fund more government services. They certainly prefer it in Texas, as Mr. Perry’s re-election record will attest.

A large part of the Texas insurance problem is a byproduct of its economic choices. Only about 50% of Texans have coverage through their jobs, compared to the national rate of 59%, because the state is home to so many new and small businesses that often don’t sponsor coverage. It is also home to many young people and immigrants (both legal and illegal), who are the least likely demographic groups to have coverage.

None of this is to gainsay the genuine hardships that many of the uninsured face, but we prefer the approach Mr. Obama ran on in the 2008 primaries against Hillary Clinton. Then he argued that people were uninsured not because they didn’t want coverage but because it was too expensive. Health costs are rising in Texas as fast as anywhere, though Mr. Perry has made some progress in attracting doctors to the state with his medical malpractice reforms that have reduced an acute provider shortage in many counties.

The Texas health-care record is not perfect, and in particular its low Medicaid payment rates are straining providers. But the point will soon be moot as Washington moves to run everything via ObamaCare. The chance to increase coverage in Texas and everywhere else through market-based reforms would be a good problem to have.