Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states.^[1] People served by Medicaid are U.S. citizens or legal permanent residents, including low-income adults, their children, and people with certain disabilities. Poverty alone does not necessarily qualify someone for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States.

Features[link]

Beginning in the 1990s, many states received waivers from the federal government to create Medicaid managed care programs. Under managed care, Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. The health plan is then responsible for providing for all or most of the recipient's healthcare needs. Today, all but a few states use managed care to provide coverage to a significant proportion of Medicaid enrollees. Nationwide, roughly 60% of enrollees are enrolled in managed care plans.^[2] Core eligibility groups of poor children and parents are most likely to be enrolled in managed care, while the aged and disabled eligibility groups more often remain in traditional "fee for service" Medicaid.

Some states operate a program known as the Health Insurance Premium Payment Program (HIPP). This program allows a Medicaid recipient to have private health insurance paid for by Medicaid. As of 2008 relatively few states had premium assistance programs and enrollment was relatively low. Interest in this approach remained high, however.^[3]

Included in the Social Security program under Medicaid are dental services. These dental services are an optional service for adults above the age of 21; however, this service is a requirement for those eligible for Medicaid and below the age of 21.^[4] Minimum services include pain relief, restoration of teeth and maintenance for dental health. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a mandatory Medicaid program for children that aims to focus on prevention on early diagnosis and treatment of medical conditions.^[4] Oral screenings are not required for EPSDT recipients and they do not suffice as a direct dental referral. If a condition requiring treatment is discovered during an oral screening, the state is responsible for taking care of this service, regardless of whether it is covered on that particular Medicaid plan.^[5]

History[link]

Medicaid was created by the Social Security Amendments of 1965 which added Title XIX to the Social Security Act. Each state administers its own Medicaid program while the federal Centers for Medicare and Medicaid Services (CMS) monitors the state-run programs and establishes requirements for service delivery, quality, funding, and eligibility standards.

The Medicaid Drug Rebate Program and the Health Insurance Premium Payment Program (HIPP) were created by the Omnibus Budget Reconciliation Act of 1990 (OBRA-90). This act helped to add Section 1927 to the Social Security Act of 1935 which became effective on January 1, 1991. This program was formed due to the costs that Medicaid programs were paying for outpatient drugs at their discounted prices.^[6]

The Omnibus Budget Reconciliation Act of 1993 (OBRA-93) amended Section 1927 of the Act as it brought changes to the Medicaid Drug Rebate Program,^[6] as well as requiring states to implement a Medicaid estate recovery program to sue the estate of decedents for medical care costs paid by Medicaid.^[7]

In 1997, the Balanced Budget Act of 1997 added the Children's Health Insurance Program.

In 2010, the Patient Protection and Affordable Care Act expanded Medicaid eligibility starting in 2014; people with income up to 133% of the poverty line qualify for coverage, including adults without dependent children.^[8][9]

State implementations[link]

States may bundle together the administration of Medicaid with other programs such as the Children's Health Insurance Program (CHIP), so the same organization that handles Medicaid in a state may also manage the additional programs. Separate programs may also exist in some localities that are funded by the states or their political subdivisions to provide health coverage for indigents and minors.

State participation in Medicaid is voluntary; however, all states have participated since 1982 when Arizona formed its Arizona Health Care Cost Containment System (AHCCCS) program. In some states Medicaid is subcontracted to private health insurance companies, while other states pay providers (i.e., doctors, clinics and hospitals) directly.

Most states administer Medicaid through their own programs. A few of those programs are listed below:

• California: Medi-Cal
• Massachusetts: MassHealth
• Oregon: Oregon Health Plan
• Oklahoma: Soonercare
• Tennessee: TennCare

Enrollment[link]

According to CMS, the Medicaid program provided health care services to more than 46.0 million people in 2001.^[10][11] In 2002, Medicaid enrollees numbered 39.9 million Americans, the largest group being children ^[12] (18.4 million or 46 percent). Some 43 million Americans were enrolled in 2004 (19.7 million of them children) at a total cost of $295 billion. In 2008, Medicaid provided health coverage and services to approximately 49 million low-income children, pregnant women, elderly people, and disabled people. In California, about 23% of the population was enrolled in Medi-Cal for at least 1 month in 2009-10.^[13]

Medicaid payments currently assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States. The federal government pays on average 57 percent of Medicaid expenses.

Loss of income and medical insurance coverage during the 2008-2009 recession resulted in a substantial increase in Medicaid enrollment in 2009. Nine U.S. states showed an increase in enrollment of 15% or more, resulting in heavy pressure on state budgets.^[14]

Comparisons with Medicare[link]

Medicare is a social insurance program funded entirely at the federal level^[15] and focuses primarily on the older population. As stated in the CMS website,^[16] Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end stage renal disease. The Medicare Program provides a Medicare part A which covers hospital bills, Medicare Part B which covers medical insurance coverage, and Medicare Part D which covers prescription drugs.

Medicaid is a program that is not solely funded at the federal level. States provide up to half of the funding for the Medicaid program. In some states, counties also contribute funds. Unlike the Medicare entitlement program, Medicaid is a means-tested, needs-based social welfare or social protection program rather than a social insurance program. Eligibility is determined largely by income. The main criterion for Medicaid eligibility is limited income and financial resources, a criterion which plays no role in determining Medicare coverage. Medicaid covers a wider range of health care services than Medicare. Some people are eligible for both Medicaid and Medicare and are known as Medicare dual eligibles.^[17] In 2001, about 6.5 million Americans were enrolled in both Medicare and Medicaid.

Eligibility[link]

Medicaid is a joint federal-state program that provides health coverage or nursing home coverage to certain categories of low-asset people, including children, pregnant women, parents of eligible children, people with disabilities and elderly needing nursing home care. Medicaid was created to help low-asset people who fall into one of these eligibility categories "pay for some or all of their medical bills."^[18]

There are two general types of Medicaid coverage. "Community Medicaid" helps people who have little or no medical insurance. Medicaid nursing home coverage pays all of the costs of nursing homes for those who are eligible except that the recipient pays most of his/her income toward the nursing home costs, usually keeping only $66.00 a month for expenses other than the nursing home.

While Congress and the Centers for Medicare and Medicaid Services (CMS) set out the general rules under which Medicaid operates, each state runs its own program. Under certain circumstances, an applicant may be denied coverage. As a result, the eligibility rules differ significantly from state to state, although all states must follow the same basic framework.

Poverty[link]

Having limited assets is one of the primary requirements for Medicaid eligibility, but poverty alone does not qualify a person to receive Medicaid benefits unless they also fall into one of the defined eligibility categories.^[19] According to the CMS website, "Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups."^[19] In 2010, the Patient Protection and Affordable Care Act expanded Medicaid eligibility starting in 2014; people with income up to 133% of the poverty line qualify for coverage, including adults without dependent children.^[8][9]

Categories[link]

There are a number of Medicaid eligibility categories; within each category there are requirements other than income that must be met. These other requirements include, but are not limited to, assets, age, pregnancy, disability, blindness, income and resources, and one's status as a U.S. citizen or a lawfully admitted immigrant.^[20]

The Deficit Reduction Act of 2005 (DRA) requires that anyone seeking Medicaid must produce documents to prove that he or she is a United States citizen or resident alien. An exception is made for Emergency Medicaid where payments are allowed for the pregnant and disabled regardless of immigration status.^[21][22] Special rules exist for those living in a nursing home and disabled children living at home. A child may be covered under Medicaid if it is a U.S. citizen or a permanent resident.

A child may be eligible for Medicaid regardless of the eligibility status of its parents or guardians. Thus, a child can be covered by Medicaid based on its individual status even if its parents are not eligible. Similarly, if a child lives with someone other than a parent, it may still be eligible based on its individual status.^[23]

Coverage and Utilization[link]

One-third of children and over half (59%) of low-income children are insured through Medicaid or SCHIP. The insurance provides them with access to preventative and primary services which are utilized at a much higher rate than for the uninsured, but still below the utilization of privately insured patients. As of February 2011, a record 90% of children have coverage. However, 8 million children remain uninsured, including 5 million who are eligible for Medicaid and SCHIP but not enrolled.^[24]

Dental[link]

Children enrolled in Medicaid are individually entitled under the law to comprehensive preventive and restorative dental services, dental care utilization for this population is low. The reasons for low utilization are many, but a lack of dental providers who participate in Medicaid is a key factor.^[25][26] Group dental practices are some of the few dentists who accept children and adults insured with Medicaid.^[27] Few dentists participate in Medicaid – less than as half of all active private dentists in some areas.^[28] Low reimbursement rates, complex forms and burdensome administrative requirements are commonly cited by dentists as reasons for not participating in Medicaid.^[29][30]

HIV[link]

Medicaid provided the largest portion of federal money spent on health care for people living with HIV/AIDS until the implementation of Medicare Part D when the prescription drug costs for those eligible for both Medicare and Medicaid shifted to Medicare. Unless low income people who are HIV positive meet some other eligibility category, they must progress to AIDS (T-cell count drops below 200) before they can qualify under the "disabled" category to receive Medicaid assistance.^[31] The Medicaid eligibility policy contrasts with the Journal of the American Medical Association (JAMA) guidelines which recommend therapy for all patients with T-cell counts of 350 or less, or in certain patients even higher. Due to the high costs associated with HIV medications, many patients are not able to begin antiretroviral treatment without Medicaid help. More than half of people living with AIDS in the US are estimated to receive Medicaid payments. Two other programs that provide financial assistance to people living with HIV/AIDS are the Social Security Disability Insurance (SSDI) and the Supplemental Security Income.

Supplemental Security Income Beneficiaries[link]

Once someone is approved as a beneficiary in the Supplemental Security Income program they may automatically be eligible for Medicaid coverage (depending on the laws of the state they reside in).

Assets[link]

Both the federal government and state governments have made changes to the eligibility requirements and restrictions over the years. The Deficit Reduction Act of 2005 (DRA) significantly changed the rules governing the treatment of asset transfers and homes of nursing home residents.^[32] The implementation of these changes proceeded state-by-state over the next few years and has now been substantially completed.

Five year "look-back"[link]

The DRA created a five-year "look-back period." That means that any transfers without fair market value (gifts of any kind) made by the Medicaid applicant during the preceding five years are penalizable, dollar for dollar. All transfers made during the five-year look-back period are totaled, and the applicant is penalized that amount after having already dropped below the Medicaid asset limit. This means that after dropping below the asset level ($2,000 limit in most states), the Medicaid applicant then has to re-pay all transfers during the preceding five years by private-paying for nursing home costs. Since the person has less than $2,000, there is no source of funds to pay the penalty. Elders who gift or transfer assets can be caught in the situation of having no money but still not being eligible for Medicaid.

No gifting[link]

There is widespread misconception about what a senior can legally gift during the look-back period without Medicaid penalties. The annual IRS gifting exclusion is $13,000 a year as of 2009. But this gift exclusion is only a federal gift tax rule: if a person gifts $13,000 or less during a year, that gift is not required to be reported and does not generate gift tax liability for the donor or the recipient. However, Medicaid has never honored the annual gift tax exclusion. Gifts of any size during the five years preceding a Medicaid application are totaled and penalized dollar for dollar.

Medicaid planners typically advise retirees and other people facing high nursing home costs to adopt strategies that will protect their financial assets in the event of nursing home admission. State Medicaid programs do not consider the value of one's home in calculating eligibility, therefore it is often recommended that retirees pursue home ownership. By adopting the recommended strategies, many seniors hope they will quickly qualify for Medicaid benefits if the need for long-term care arises.

A cottage industry has developed with attorneys providing "Medicaid planning" for those in a nursing home or likely to be admitted. The attorneys develop plans to convert countable assets to exempt assets, thereby making an elder with excess assets eligible. Planning techniques can also prevent the homestead from being lost to a Medicaid lien. Legal asset protection can be done at any point since a conversion of a countable asset to an exempt asset is not a transfer without fair market value and is therefore not subject to the five-year look-back period.

Budget[link]

Medicaid spending as part of total U.S. healthcare spending (public and private). Percent of gross domestic product (GDP). Congressional Budget Office chart.^[33]

Unlike Medicare, which is solely a federal program, Medicaid is a joint federal-state program. Each state operates its own Medicaid system, but this system must conform to federal guidelines in order for the state to receive matching funds and grants.^[34] The matching rate provided to states is determined using a federal matching formula (called Federal Medical Assistance Percentages), which generates payment rates that vary from state to state, depending on each state's respective per capita income.^[35] The wealthiest states only receive a federal match of 50% while poorer states receive a larger match.

Medicaid funding has become a major budgetary issue for many states over the last few years, with states, on average, spending 16.8% of state general funds on the program. If the federal match expenditure is also counted, the program, on average, takes up 22% of each state's budget.^[36][37] Some 43 million Americans were enrolled in 2004 (19.7 million of them children) at a total cost of $295 billion.^{[citation needed]} In 2008, Medicaid provided health coverage and services to approximately 49 million low-income children, pregnant women, elderly people, and disabled people.^{[citation needed]} Federal Medicaid outlays were estimated to be $204 billion in 2008.^[38]

Medicaid does not pay benefits to individuals directly; Medicaid sends benefit payments to health care providers. In some states Medicaid beneficiaries are required to pay a small fee (co-payment) for medical services.^[20] Medicaid is limited by federal law to the coverage of "medically-necessary services".^[39]

Medicaid payments currently assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States. The federal government pays on average 57 percent of Medicaid expenses.

On November 25, 2008, a new federal rule was passed that allows states to charge premiums and higher co-payments to Medicaid participants.^[40] This rule will enable states to take in greater revenues, limiting financial losses associated with the program. Estimates figure that states will save $1.1 billion while the federal government will save nearly $1.4 billion. However, this means that the burden of financial responsibility will be placed on 13 million Medicaid recipients who will face a $1.3 billion increase in co-payments over 5 years.^[41] The major concern is that this rule will create a disincentive for low-income people to seek healthcare. It is possible that this will force only the sickest participants to pay the increased premiums and it is unclear what long term effect this will have on the program.

Public Health Impacts[link]

A 2011 paper by the Massachusetts Institute of Technology and the Harvard School of Public Health, “The Oregon Health Insurance Experiment: Evidence from the First Year,” utilized Oregon’s 2008 decision to hold a randomized lottery for the provision of Medicaid insurance in order to measure the impact of health insurance on an individual’s health and well-being. The study examined the outcomes of the 10,000 lower-income people eligible for Medicare who were chosen by this randomized system, which helped eliminate potential bias in the data produced. The study's authors caution that the survey sample is relatively small and "estimates are therefore difficult to extrapolate to the likely effects of much larger health insurance expansions, in which there may well be supply side responses from the health care sector." Nevertheless, the study finds evidence that: 1) Hospital utilization increased by 30% for those with insurance, with the length of hospital stays increasing by 30% and the number of procedures increasing by 45% for the population with insurance; 2) Medicaid recipients proved more likely to seek preventative care. Women were 60% more likely to have mammograms, and recipients overall were 20% more likely to have their cholesterol checked; 3) In terms of self-reported health outcomes, having insurance was associated with an increased probability of reporting one’s health as “good,” “very good,” or “excellent” — overall, about 25% higher than the average; 4) Those with insurance were about 10% less likely to report a diagnosis of depression.^[42]

See also[link]

	Government of the United States portal
	Health portal
	Medicine portal

• Center for Medicare and Medicaid Innovation
• Health insurance in the United States
• Maurice Mazel
• Medicaid managed care
• State Children's Health Insurance Program (SCHIP/CHIP)
• United States National Health Care Act

References[link]

Further reading[link]

• House Ways and Means Committee, "2004 Green Book - Overview of the Medicaid Program", United States House of Representatives, 2004.

External links[link]

• CMS official web site.
  • Medicaid information
    • Healthcare information for consumers
    • Insurance information for consumers
  • Medicare
    • Medicare official web site for beneficiaries.
• Health Assistance Partnership
• Trends in Medicare, October 2006. Staff Paper of the Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services
• Read Congressional Research Service (CRS) Reports regarding Medicaid
• "Medicaid Research" and "Medicaid Primer" from Georgetown University Center for Children and Families.
• Kaiser Family Foundation - Substantial resources on Medicaid including federal eligibility requirements, benefits, financing and administration.
  • "The Role of Medicaid in State Economies: A Look at the Research," Kaiser Family Foundation, April 2004
  • State Health Facts Data on health care spending, utilization, and insurance coverage, including details extensive Medicaid information.
• Coverage By State - Information on state health coverage, including Medicaid, by the Robert Wood Johnson Foundation & AcademyHealth.
• Medicaid information from Families USA
• Medicaid Reform - The Basics from The Century Foundation
• National Association of State Medicaid Directors Organization representing the chief executives of state Medicaid programs.
• Ranking of state Medicaid programs by eligibility, scope of services, quality of service and reimbursement from Public Citizen. 2007.
• Center for Health Care Strategies, CHCS Extensive library of tools, briefs, and reports developed to help state agencies, health plans and policymakers improve the quality and cost-effectiveness of Medicaid.
• Medicare Interactive - Medicare resource presented by the Medicare Rights Center
• SSA.gov

Ron Paul
Member of the U.S. House of Representatives from Texas's 14th district
Incumbent
Assumed office January 3, 1997
Preceded by	Greg Laughlin
Member of the U.S. House of Representatives from Texas's 22nd district
In office January 3, 1979 – January 3, 1985
Preceded by	Robert Gammage
Succeeded by	Tom DeLay
In office April 3, 1976 – January 3, 1977
Preceded by	Robert Casey
Succeeded by	Robert Gammage
Personal details
Born	Ronald Ernest Paul (1935-08-20) August 20, 1935 (age 76) Pittsburgh, Pennsylvania, U.S.
Political party	Republican Party (1976–1988, 1988–present)
Other political affiliations	Libertarian Party (1988 election)
Spouse(s)	Carol Wells
Children	Ronnie Lori Rand Robert Joy
Alma mater	Gettysburg College (B.S.) Duke University (M.D.)
Religion	Southern Baptist
Signature
Website	Congressional website Campaign website
Military service
Service/branch	United States Air Force Texas Air National Guard
Years of service	1963–1965 1965–1968
Rank	Captain[1]
This article is part of a series about Ron Paul 2012 presidential campaign 2008 presidential campaign 1988 presidential campaign Political positions · Electoral history List of legislation sponsored by Ron Paul Ron Paul newsletters Ron Paul bibliography

Ronald Ernest "Ron" Paul (born August 20, 1935) is an American politician who has been the U.S. Representative for Texas's 14th congressional district, which includes Galveston, since 1997, and a three-time candidate for President of the United States, as a Libertarian in 1988 and as a Republican in 2008 and currently 2012. He is an outspoken critic of American foreign and monetary policies, including the Military–industrial complex and the Federal Reserve, and is known for his libertarian-leaning views, often differing from his own party on certain issues.

A native of Pittsburgh, Pennsylvania, Paul is a graduate of Gettysburg College and Duke University School of Medicine, where he earned his medical degree. He served as a medical officer in the United States Air Force from 1963 until 1968. He worked as an obstetrician-gynecologist from the 1960s to the 1980s, delivering more than 4,000 babies. He became the first Representative in history to serve concurrently with a child in the Senate when his son Rand Paul was elected to the United States Senate for Kentucky in 2010.^[2]

Ron Paul has been an active writer and publisher since the late 1970s, when he created the first of several newsletters bearing his name. He has published many books, beginning with The Case for Gold (1982) and including Liberty Defined: 50 Essential Issues That Affect Our Freedom (2011), End The Fed (2009), The Revolution: A Manifesto (2008), Pillars of Prosperity (2008), and A Foreign Policy of Freedom: Peace, Commerce, and Honest Friendship (2007). Paul has been characterized as the "intellectual godfather" of the Tea Party movement.^[3][4]

On July 12, 2011, Paul announced that he would forego seeking another term in Congress in order to focus on his presidential bid.^[5] On May 14, 2012, Paul announced that he would not be competing in any other Presidential primaries, though he is still competing for delegates in states where the primary election have already been held.^[6]

Early life, education, and medical career[link]

Ronald Ernest Paul was born on August 20, 1935, in Pittsburgh,^[7] the son of Howard Caspar Paul, who ran a small dairy company, and Margaret (née Dumont) Paul. His paternal great-grandparents emigrated from Germany, and his mother was of German and Irish ancestry.^[8][9]

As a junior at suburban Dormont High School, he was the 220-yard dash state champion.^[10] He graduated from Gettysburg College with a B.S. degree in Biology in 1957.^[10]

Paul earned a Doctor of Medicine degree from Duke University's School of Medicine in 1961, and completed his medical internship at the Henry Ford Hospital in Detroit and his residency in obstetrics and gynecology at Magee-Womens Hospital in Pittsburgh.^[11] Paul served as a flight surgeon in the United States Air Force from 1963 to 1965 and then in the United States Air National Guard from 1965 to 1968.^[12]

Paul and his wife then relocated to Texas, where he began a private practice in obstetrics and gynecology.^[13] He refused to accept Medicaid or Medicare payments, but routinely lowered fees for patients who could not afford to pay.^[14][15]

Early congressional career (1976–1985)[link]

While still a medical resident in the 1960s, Paul was influenced by Friedrich Hayek's The Road to Serfdom, which caused him to read many publications by Ludwig von Mises and Ayn Rand. He came to know economists Hans Sennholz and Murray Rothbard well, and credits to them his interest in the study of economics.^[16]

When President Richard Nixon "closed the gold window" by ending American participation in the Bretton Woods System, thus ending U.S. dollar's loose association with gold^[16] on August 15, 1971, Paul decided to enter politics^[17] and became a Republican candidate for the United States Congress.^[18]

Elections[link]

In 1974, incumbent Robert R. Casey defeated him for the 22nd district. President Gerald Ford later appointed Casey to direct the Federal Maritime Commission, and Paul won an April 1976 special election to the vacant office.^[19] Paul lost the next regular election to Democrat Robert Gammage by fewer than 300 votes (0.2%), but defeated Gammage in a 1978 rematch, and was reelected in 1980 and 1982.^[20] Gammage underestimated Paul's popularity among local mothers: "I had real difficulty down in Brazoria County, where he practiced, because he'd delivered half the babies in the county. There were only two obstetricians in the county, and the other one was his partner."^[21]

Tenure[link]

Paul has served in Congress three different periods: first from 1976 to 1977, after he won a special election, then from 1979 to 1985, and finally since 1997.

In his early years, Paul served on the House Banking Committee, where he blamed the Federal Reserve for inflation and spoke against the banking mismanagement that resulted in the savings and loan crisis.^[22][8] Paul argued for a return to the gold standard maintained by the US from 1873-1933, and with Senator Jesse Helms convinced the Congress to study the issue.^[16] He spoke against the reinstatement of registration for the military draft in 1980, in opposition to President Jimmy Carter and the majority of his fellow Republican members of Congress.^[23]

During his first term, Paul founded the Foundation for Rational Economics and Education (FREE), a non-profit "think tank" dedicated to promoting principles of limited government and free-market economics.^[24]

Paul proposed term-limit legislation multiple times, while himself serving four terms in the House of Representatives.^[23] In 1984, he decided to retire from the House in order to run for the U.S. Senate, complaining in his House farewell address that "Special interests have replaced the concern that the Founders had for general welfare.... It's difficult for one who loves true liberty and utterly detests the power of the state to come to Washington for a period of time and not leave a true cynic."^[25][26] (On Paul's departure from the House, his congressional seat was assumed by former state representative Tom DeLay, who would eventually become Speaker of the House.)^[27]

Committee assignments[link]

• House Banking Committee

1984 U.S. Senate election[link]

In 1984, Paul campaigned for the U.S. Senate, but lost the Republican primary to Phil Gramm, who had switched parties the previous year from Democrat to Republican.^[28] Another candidate of the senatorial primary was Henry Grover, a conservative former state legislator who had lost the 1972 gubernatorial general election to the Democrat Dolph Briscoe, Jr.

Inter-congressional years[link]

1985–1997[link]

Following the loss of the 1984 senate race, Paul returned to his obstetrics practice and took part in a number of other business ventures.^[8][29] Along with his former congressional chief of staff, Lew Rockwell, Paul founded a for-profit enterprise, Ron Paul & Associates, Inc. (RP&A) in 1984, with Paul serving as president, Rockwell as vice president, Paul's wife Carol as secretary, and daughter Lori Pyeatt as treasurer.^[30] The company published a variety of political and investment-oriented newsletters including Ron Paul Freedom Report and Ron Paul Survival Report, and by 1993 was generating revenues in excess of $900,000.^[31][32]

Paul also co-owned a mail-order coin dealership, Ron Paul Coins, for twelve years with Burt Blumert, who continued to operate the dealership after Paul resumed office in 1996.^[33][34] Paul spoke multiple times at the American Numismatic Association's 1988 convention.^[33] He worked with his Foundation for Rational Economics and Education on such projects as establishing the National Endowment for Liberty, producing the At Issue public policy series that was broadcast on the Discovery Channel and CNBC,^[24] and continuing publication of newsletters.

1988 presidential campaign[link]

Paul resigned from the Republican Party in 1987 and launched a bid for the presidency running on the Libertarian Party ticket. At the 1987 Libertarian National Convention, the party was split between a Conservative and Liberal wing. Paul represented the conservative wing, which was successful in fundraising, while the liberal wing claimed to have received ten times more (and more favorable) press coverage.^{[citation needed]} Paul argued, "Pro-life libertarians have a vital task to perform: to persuade the many abortion-supporting libertarians of the contradiction between abortion and individual liberty; and to sever the mistaken connection in many minds between individual freedom and the 'right' to extinguish individual life."^[35][36]

In the 1988 presidential election, Paul was on the ballot in 46 States,^[37] scoring third in the popular vote with 432,179 votes (0.5%).^[38] Paul was kept off the ballot in Missouri, and received votes there only when written in, due to what the St. Louis Post-Dispatch termed a "technicality".^[39]

According to Paul, his presidential campaign was about more than obtaining office; he sought to promote his libertarian ideas, often to school and university groups regardless of vote eligibility. He said, "We're just as interested in the future generation as this election. These kids will vote eventually, and maybe, just maybe, they'll go home and talk to their parents."^[37]

Paul considered campaigning for President during 1992,^[40] but instead chose to endorse Pat Buchanan that year, and served as an adviser to Buchanan's Republican presidential primary campaign against incumbent President George H. W. Bush.^[41]

Later congressional career (1997–present)[link]

An earlier congressional portrait of Paul

Elections[link]

1996 campaign

During 1996, Paul was re-elected to Congress after a difficult campaign. The Republican National Committee endorsed incumbent Greg Laughlin in the primary; Paul won with assistance from baseball pitcher, constituent, and friend Nolan Ryan, tax activist and publisher Steve Forbes^[8] and conservative commentator Pat Buchanan (both of whom had had presidential campaigns that year). Paul narrowly defeated Democratic attorney Charles "Lefty" Morris in the fall election, despite Morris' criticism over controversial statements in several newsletters that Ron Paul published.

1998–present

In 1998 and 2000, Paul defeated Loy Sneary, a Democratic Bay City, Texas, rice farmer and former Matagorda County judge.^[17] In the 2008 Republican primary,^[42] he defeated Friendswood city councilman Chris Peden,^[43] with over 70 percent of the vote^[44] and ran unopposed in the general election.^[45] In the 2010 Republican primary, Paul defeated three opponents with 80 percent of the vote.^[46]

On July 12, 2011, Paul announced that he would not seek re-election to the House in order to pursue the 2012 presidential election.^[47][48]

Tenure[link]

Legislation

Of the 620 bills that Paul had sponsored through December 2011, over a period of more than 22 years in Congress, only one had been signed into law – a lifetime success rate of less than 0.3%.^[49] The sole measure authored by Paul that was ultimately enacted allowed for a federal customhouse to be sold to a local historic preservation society (H.R. 2121 in 2009).^[49]

By amending other legislation, he has helped prohibit funding for national identification numbers, funding for federal teacher certification,^[17] International Criminal Court jurisdiction over the U.S. military, American participation with any U.N. global tax, and surveillance of peaceful First Amendment activities by citizens.^[50]

Affiliations

Paul was honorary chairman of, and is a member of the Republican Liberty Caucus, a political action committee that describes its goal as electing "liberty-minded, limited-government individuals".^[51] He is an initiating member of the Congressional Rural Caucus, which deals with agricultural and rural issues, and the 140-member Congressional Wildlife Refuge Caucus.^[52]

Committee assignments[link]

Rep. Paul serves on the following committee and subcommittees.^[53]

• Committee on Financial Services
  • Subcommittee on Domestic Monetary Policy and Technology (Chairman)
  • Subcommittee on International Monetary Policy and Trade
• Committee on Foreign Affairs
  • Subcommittee on Oversight and Investigations

With the election of the 112th Congress, and a resulting GOP majority in the House, Paul became the chairman of the Subcommittee on Domestic Monetary Policy and Technology starting in January 2011.^[54]

2008 presidential campaign[link]

Ron Paul being interviewed the day of the New Hampshire primary in Manchester

2008 Republican primary campaign[link]

Paul formally declared his candidacy for the 2008 Republican nomination on March 12, 2007, on C-SPAN.^[55] Few major politicians endorsed him, and his campaign was largely ignored by traditional media.^[56] However, he attracted an intensely loyal grassroots following, in large part energized by "iconoclastic white men"^[57] interacting through internet social media.^[58][59][60] In May 2007, shortly after the first televised primary debates, the blogs search engine site Technorati.com listed Paul's name as the term most frequently searched for;^[58] and Paul's campaign claimed that Paul had more YouTube channel subscribers than Barack Obama or any other candidate for president.^[61] For a candidate who had had relatively low national name recognition prior to entering the race, Paul did surprisingly well in fundraising, taking in more money than any other Republican candidate in the fourth quarter of 2007, as the primary season headed into the Iowa caucuses.^[62][63]

Despite benefiting from large numbers of campaign contributions from individual donors,^[64] and the efforts of tech-savvy supporters determined to keep his name a frequent topic of discussion on the internet,^[58] over the course of the campaign Paul was unable to translate the enthusiasm of his core supporters into large enough numbers of actual primary votes to unseat his rivals.

Paul came in 5th place in both the January 4 Iowa caucuses (10% of votes cast)^[65] and the January 8 New Hampshire primary (8%).^[66] With the exception of the Nevada caucuses January 19, where he came in 2nd (14%) behind Romney (51%), he did little better through the rest of January: Michigan 4th (6%), South Carolina 5th (4%), Florida 5th (3%). On SuperTuesday, February 5, he placed 4th in almost every state, generally taking in a mere 3–6% of the votes (although he did better in the mountain states of North Dakota (21%, 3rd place) and Montana (25%, 2nd place).^[67][68]

By March, front-runner John McCain had secured enough pledged delegates to guarantee that he would win the nomination, and Romney and Huckabee had both formally withdrawn from the race. Paul, who had won no state primaries, knew that it was now mathematically impossible for him to win the nomination, as he had captured only 20^[69] – 40 pledged delegates compared to more than 1,191 for McCain, yet he refused to concede the race and said that it was unlikely that he would ultimately endorse McCain.^[70][71][72] Over the next few weeks, Paul's supporters clashed with establishment Republicans at several county and state party conventions over state party rules, the party platforms, and selection of delegates for the national convention.^[73][74][75] In one of the more dramatic moments, Nevada's state party leaders, outmaneuvered by Paul supporters at the state nominating convention, resorted to the highly unusual measure of prematurely and abruptly shutting down the convention before selecting national delegates, with a plan to reconvene at a later date.^[76][77]

On June 12, 2008, Paul finally withdrew his bid for the Republican nomination. He later said that one of the reasons he did not run in the general election as a third-party candidate, after losing the primary election, was that, as a concession to gain ballot access in certain states, he had signed legally-binding agreements to not run a third-party campaign if he lost the primary.^[78] Some of the $4 million remaining campaign contributions was invested into the new political action and advocacy group called Ron Paul's Campaign for Liberty.^[79]

Refusal to endorse the Republican candidate[link]

At a September 10, 2008, press conference, Paul announced his general support of four third-party candidates: Cynthia McKinney (Green Party); Bob Barr (Libertarian Party); Chuck Baldwin (Constitution Party); and Ralph Nader (independent). He said that each of them had pledged to adhere to a policy of balancing budgets, bringing the troops home, defending privacy and personal liberties, and investigating the Federal Reserve. Paul also said that under no circumstances would he be endorsing either of the two dominant parties' candidates (McCain – Republican Party, or Obama – Democratic Party) because there were no real differences between them, and because neither of them, if elected, would seek to make the fundamental changes in governance that were necessary. He urged instead that, rather than contribute to the “charade” that the two-party election system had become, the voters support the third-party candidates as a protest vote, to force change in the election process.^[80][81] Later that same day, Paul gave a televised interview with Nader saying much the same again.^[82]

Two weeks later, "shocked and disappointed" that Bob Barr (the Libertarian candidate) had pulled out of attending the press conference at the last minute and had admonished Paul for remaining neutral and failing to say which specific candidate Paul would vote for in the general election, Paul released a statement saying that he had decided to endorse Chuck Baldwin, the Constitution Party candidate, for president.^[83]

In the November 2008 general election, Paul received 41,905 votes despite not actively campaigning.^[84][85]

2012 presidential campaign[link]

Ron Paul during his 2012 presidential election campaign in Las Vegas, Nevada.

Paul is a candidate for the Republican Party nomination for President of the United States in the 2012 election.

He won several early straw polls for the 2012 Republican presidential nomination ^[86] and in late April, 2011, he formed an official exploratory committee.^[87][88] He participated in the first Republican presidential debate on May 5, 2011.^[89] and on May 13, 2011, Paul formally announced his candidacy in an interview on ABC's Good Morning America.^[90] He placed second in the 2011 Ames Straw Poll, missing first by 0.9%.^[91]

In December 2011, with Ron Paul's increased support, the controversy over allegedly racist and homophobic statements in several Ron Paul newsletters in the 1980s and early 1990s once again gained media attention.^[92] During this time Paul supporters asserted that he was continually ignored by the media despite his significant support, citing examples of where television news shows would fail to mention Paul in discussions of the Republican presidential hopefuls even when he was polling second.^{[93][94][95][96]}

Paul came in third in the Iowa Republican Caucus held on January 3, 2012. Out of a turnout of 121,503 votes, Paul took 26,036 (21%) of the certified votes. Rick Santorum and Mitt Romney finished in a virtual tie for first place with 25% each.^[97] In the New Hampshire Primary held on January 10, 2012, Paul received 23% of the votes and came in second after Romney's 39%.^[98]

Ron Paul's results then declined, despite the withdrawal of candidates Michele Bachmann, Jon Huntsman and Rick Perry. He had fourth place finishes in the next two primaries, on January 21st in South Carolina (with 13% of the vote^[99]) and on January 31st in Florida (where he received 7% of the vote.^{[100][101][102]})

On February 4, Paul finished third in Nevada with 18.8% of the vote.^[103] Three non-binding primaries were held on February 7th; Paul took 3rd place in Colorado^[104] and Missouri^[105] with 13% and 12% of the vote respectively. He fared better in Minnesota^[106] with 27%, finishing second to Rick Santorum.

On May 14, Paul's campaign announced that due to lack of funds he would no longer actively campaign for votes in the 11 remaining primary states, including Texas and California, that had not yet voted.^[6][107] He would, however, continue to seek to win delegates for the national party convention in the states that had already voted.

Political party identification[link]

Throughout his entire tenure in Congress, Paul has represented his district as a member of the Republican Party. However, he has frequently taken positions in direct opposition to the other members and the leadership of the party, and he has sometimes publicly questioned whether he really belonged in the party.

He had been a lifelong supporter of the Republican Party by the time he entered politics in the mid 1970s.^[108] He was one of the first elected officials in the nation to support Ronald Reagan's presidential campaign,^[109] and he actively campaigned for Reagan in 1976 and 1980.^[110] After Reagan's election in 1980, Paul quickly became disillusioned with the Reagan administration's policies. He later recalled being the only Republican to vote against Reagan budget proposals in 1981,^[111][112] aghast that "in 1977, Jimmy Carter proposed a budget with a $38 billion deficit, and every Republican in the House voted against it. In 1981, Reagan proposed a budget with a $45 billion deficit – which turned out to be $113 billion – and Republicans were cheering his great victory. They were living in a storybook land."^[109] He expressed his disgust with the political culture of both major parties in a speech delivered in 1984 upon resigning from the House of Representatives to prepare for a (failed) run for the Senate, and he eventually apologized to his Libertarian friends for having supported Reagan.^[111]

Wikisource has original text related to this article: Ron Paul's 1987 Resignation Letter to the RNC

By 1987, Paul was ready to sever all ties to the Republican Party, as he explained in a blistering resignation letter: "Since [1981] Ronald Reagan and the Republican Party have given us skyrocketing deficits, and astoundingly a doubled national debt. How is it that the party of balanced budgets, with control of the White House and Senate, accumulated red ink greater than all previous administrations put together? ... There is no credibility left for the Republican Party as a force to reduce the size of government. That is the message of the Reagan years."^[110][108] A month later he announced he would seek the 1988 Libertarian Party nomination for president.

During the 1988 campaign, Paul called Reagan "a dramatic failure"^[110] and complained that "Reagan's record is disgraceful. He starts wars, breaks the law, supplies terrorists with guns made at taxpayers' expense and lies about it to the American people."^[113] Paul predicted that "the Republicans are on their way out as a major party,"^[111] and he said that, although registered as a Republican, he had always been a Libertarian at heart.^[112][111]

Paul returned to his private medical practice and managing several business ventures after losing the 1988 election; but by 1996, he was ready to return to politics, this time running on the Republican Party ticket again. He said that he had never read the entire Libertarian platform when he ran for president as a Libertarian in 1988, and that "I worked for the Libertarians on my terms, not theirs."^[114] He added that in terms of a political label he preferred to call himself "a constitutionalist. In Congress I took an oath to uphold the Constitution, not the (Republican) platform."^[114]

When he lost the Republican Party presidential primary election in 2008, Paul criticized the two major political parties, saying that there was no real difference between the parties and that neither of them truly intended to challenge the status quo. He refused to endorse the Republican Party's nominee for president, John McCain, and lent his support to third-party candidates instead.^[115][116]

In 2012 presidential campaign, during which he acknowledged it was unlikely that he would win the Republican Party nomination,^[117] Paul again asserted that he was participating in the Republican Party on his own terms, trying to persuade the rest of the party to move toward his positions rather than joining in with theirs.^[118] He expressed doubt that he would support any of his rivals should they win the nomination, warning that, “If the policies of the Republican Party are the same as the Democrat Party and they don't want to change anything on foreign policy, they don't want to cut anything, they don't want to audit the Fed and find out about monetary policy, they don't want to have actual change in government, that is a problem for me."^[119] On that same theme he said in another interview, "I would be reluctant to jump on board and tell all of the supporters that have given me trust and money that all of a sudden, I'd say, [all] we've done is for naught. So, let's support anybody at all ... even if they disagree with everything that we do."^[120]

Political positions[link]

Paul at the 2007 National Right to Life Committee Convention in Kansas City, Missouri, June 15, 2007.

Paul has been described as conservative and libertarian.^[8] According to University of Georgia political scientist Keith Poole, Paul had the most conservative voting record of any member of Congress from 1937 to 2002,^[121] and is the most conservative of the candidates seeking the 2012 Republican nomination for president,^[122] on a scale primarily measuring positions on the role of government in managing the economy – not positions on social issues or foreign policy matters.^[123] Other analyses, in which key votes on domestic social issues and foreign policy factor more heavily, have judged Paul much more moderate. The National Journal, for instance, rated Paul only the 145th most conservative member of the House of Representatives based on votes cast in 2010.^[124][125]

The foundation of Paul's political philosophy is the conviction that "the proper role for government in America is to provide national defense, a court system for civil disputes, a criminal justice system for acts of force and fraud, and little else."^[126] He has been nicknamed "Dr. No,"^[17] reflecting both his medical degree and his insistence that he will "never vote for legislation unless the proposed measure is expressly authorized by the Constitution."^[22]

Paul is a proponent of Austrian School economics; he has authored six books on the subject, and displays pictures of Austrian School economists Friedrich Hayek, Murray Rothbard, and Ludwig von Mises (as well as of Grover Cleveland)^[127] on his office wall. He regularly votes against almost all proposals for new government spending, initiatives, or taxes;^[128] he cast two thirds of all the lone negative votes in the House during a 1995–1997 period.^[17]

He has pledged never to raise taxes^[129] and states he has never voted to approve a budget deficit. Paul believes that the country could abolish the individual income tax by scaling back federal spending to its fiscal year 2000 levels;^[130][131] financing government operations would be primarily by excise taxes and non-protectionist tariffs. He endorses eliminating most federal government agencies, terming them unnecessary bureaucracies.

On April 15, 2011, Paul was one of four Republican members of Congress to vote against Rep. Paul Ryan's budget proposal, known as "The Path to Prosperity."^[132]

Paul has a consistent record as an inflation hawk, having warned of hyperinflation as far back as 1981.^[133] While Paul believes the longterm decrease of the U.S. dollar's purchasing power by inflation is attributable to its lack of any commodity backing, he does not endorse a "return" to a gold standard – as the U.S. government has established during the past – but instead prefers to eliminate legal tender laws and to remove the sales tax on gold and silver, so that the market may freely decide what type of monetary standard(s) there shall be.^[134] Since 1999, he has introduced bills into each Congress seeking to eliminate the Federal Reserve System in a single year.^{[135][136][137]}

Paul's foreign policy of nonintervention^[138] made him the only 2008 Republican presidential candidate to have voted against the Iraq War Resolution in 2002. He advocates withdrawal from the United Nations, and from the North Atlantic Treaty Organization, for reasons of maintaining strong national sovereignty.^[139]

He endorses free trade, rejecting membership in the North American Free Trade Agreement (NAFTA) and the World Trade Organization as "managed trade". He endorses increased border security and opposes welfare for illegal aliens, birthright citizenship and amnesty;^[140] he voted for the Secure Fence Act of 2006. He voted for the Authorization for Use of Military Force Against Terrorists in response to the September 11 attacks, but suggested war alternatives such as authorizing the president to grant Letters of Marque and Reprisal targeting specific terrorists. An opponent of the Iraq War and potential war with Iran, he has also criticized neoconservatism and U.S. foreign policy in the Middle East, arguing that both inadvertently cause terrorist reprisals against Americans. Paul has stated that "Israel is our close friend" and that it is not the place of the United States to "dictate how Israel runs her affairs".^[141]

Paul endorses constitutional rights, such as the right to keep and bear arms, and habeas corpus for political detainees. He opposes the Patriot Act, federal use of torture, presidential autonomy, a national identification card, warrantless domestic surveillance, and the draft. Paul also believes that the notion of the separation of church and state is currently misused by the court system: "In case after case, the Supreme Court has used the infamous 'separation of church and state' metaphor to uphold court decisions that allow the federal government to intrude upon and deprive citizens of their religious liberty."^[142]

Citing the Ninth and Tenth Amendments, Paul advocates states' rights to decide how to regulate social matters not cited directly by the Constitution. He opposes federal regulation of the death penalty^[143] (although he opposes capital punishment),^[144] of education,^[145] and of marriage, and endorsed revising the military's "don't ask, don't tell" policy to concern mainly disruptive sexual behavior (whether heterosexual or homosexual).^[146]

Paul says his years as an obstetrician led him to believe life begins at conception.^[147]

He terms himself "strongly pro-life",^[148] "an unshakable foe of abortion",^[149] and believes regulation or ban^[150] on medical decisions about maternal or fetal health is "best handled at the state level".^[143][151] His abortion-related legislation, like the Sanctity of Life Act, is intended to negate Roe v. Wade and to get "the federal government completely out of the business of regulating state matters."^[152]

Paul has stated that "The government shouldn't be in the medical business." He pushes to eliminate federal involvement with and management of health care, which he argues would allow prices to decrease due to the fundamental dynamics of a free market.^[153] Paul also opposes the federal War on Drugs,^[154] and believes the states should decide whether to regulate or deregulate drugs such as medical marijuana.^[155] He also opposes federal government influenza inoculation programs.^[156]

As a free-market environmentalist, he asserts private property rights in relation to environmental protection and pollution prevention.^{[citation needed]} He called global warming a hoax in a 2009 Fox Business interview, saying, "You know, the greatest hoax I think that has been around in many, many years if not hundreds of years has been this hoax on the environment and global warming."^[157] He acknowledges there is clear evidence of rising temperatures in some parts of the globe, but says that temperatures are cooling in other parts.^[158]

Paul was critical of the Civil Rights Act of 1964, arguing that it sanctioned federal interference in the labor market and did not improve race relations. He once remarked: "The Civil Rights Act of 1964 not only violated the Constitution and reduced individual liberty; it also failed to achieve its stated goals of promoting racial harmony and a color-blind society".^[159] Paul opposes affirmative action.^[160]

He is an outspoken proponent of increased ballot access for 3rd party candidates,^[161] but has sought to repeal the National Voter Registration Act of 1993, also known as the Motor Voter law.^[162]

Newsletters controversy[link]

Beginning in 1978, for more than two decades Paul and his associates published a number of political and investment-oriented newsletters bearing his name (Dr. Ron Paul's Freedom Report, The Ron Paul Survival Report, the Ron Paul Investment Letter, and the Ron Paul Political Report).^[163] By 1993, a business through which Paul was publishing the newsletters was earning in excess of $900,000 per year.^[163]

A number of the newsletters, particularly in the period between 1988 and 1994 when Paul was no longer in Congress, contained material that later proved highly controversial, dwelling on conspiracy theories, praising anti-government militia movements, and warning of coming race wars.^[163][164] During Paul's 1996 congressional election campaign, and his 2008 and 2012 presidential primary campaigns, critics charged that some of the passages reflected racist, anti-Semitic, and homophobic bigotry.^{[165][166][167][168][169][170][171]}

The newsletters included statements such as:

• "... I think we can safely assume that 95 percent of the black males in [Washington, DC] are semi-criminal or entirely criminal."^[166]
• "Boy, it sure burns me to have a national holiday for that pro-communist philanderer, Martin Luther King. I voted against this outrage time and time again as a Congressmen. What an infamy that Ronald Reagan approved it! We can thank him for our annual Hate Whitey Day!"^[163][172]
• "An ex-cop I know advises that if you have to use a gun on a youth [to defend yourself against armed robbery], you should leave the scene immediately, disposing of the wiped off gun as soon as possible.... I frankly don't know what to make of such advice, but even in my little town of Lake Jackson, Texas, I've urged everyone in my family to know how to use a gun in self defense. For the animals are coming."^[163][173]
• “I miss the closet. Homosexuals, not to speak of the rest of society, were far better off when social pressure forced them to hide their activities. They could also not be as promiscuous. Is it any coincidence that the AIDS epidemic developed after they came 'out of the closet,' and started hyper-promiscuous sodomy? I don't believe so, medically or morally.”^[174][175]
• “[Magic] Johnson may be a sports star, but he is dying [of AIDS] because he violated moral laws.”^[164][176]
• “[T]he criminal ‘Justice’ Department wants to force dentists to treat these Darth Vader types [people with AIDS] under the vicious Americans With Disabilities Act;" and “[W]e all have the right to discriminate, which is what freedom of association is all about, especially against killers [AIDS patients].”^[164][177]

Other passages referred to former Secretary of Health & Human Services Donna Shalala as a “short lesbian” and Martin Luther King, Jr. as a pedophile and “lying socialist satyr" – while offering praise for former Ku Klux Klan Imperial Wizard David Duke and other controversial figures.^{[163][164][174]}

When criticism of the newsletters was leveled against Paul during his 1996 congressional election, he did not deny writing the newsletters, but instead defended them and said that the material had been taken out of context.^{[165][167][166]} In later years, Paul said that the controversial material had been ghostwritten by members of a team that included 6 or 8 others and that, as publisher, not editor, he had not even been aware of the content of the controversial articles until years after they had been published.^[167][178] He eventually disavowed those passages, and stated that in 1996 his campaign advisers had thought denying authorship would be too confusing and that he had to live with the material published under his name.^[167][178] Some political commentators made note of the changing nature of the explanations he had provided over the years about his involvement with the newsletters.^{[179][180][181]}

An estranged former long-term aide of Paul, Eric Dondero, alleged that Paul was lying about his role in the production of the controversial newsletters.^[182][183] During the 2012 Republican presidential primary campaign, in January 2012, the Washington Post reported^[184] that several of Paul's former associates said that Paul had been very involved in the production of the newsletters and had allowed the controversial material to be included as part of a deliberate strategy to boost profits. Paul's former secretary said, "it was his newsletter, and it was under his name, so he always got to see the final product.... He would proof it."^[184] Paul continued to deny the accusations and to disavow the material.^[185]

Personal life[link]

Paul at a rally in Erlanger, Kentucky, on October 2, 2010, along with his son, senator Rand Paul of Kentucky, and his grandson, William Paul.

Paul has been married to Carol Wells since 1957.^[186] They met in 1952 when Wells asked Paul to be her escort to her 16th birthday party.^[187] They have five children, who were baptized Episcopalian:^[8] Ronald, Lori, Randal, Robert, and Joy. Paul's son Randal is the junior United States senator from the state of Kentucky. Raised a Lutheran, Paul later became a Baptist.^[188]

Bibliography[link]

Other contributions[link]

References[link]