Perry was speaking at an Austin business forum and had barely begun singing the state's pro-entrepreneurial praises when a woman shrieked "Expand Texas health care!" After nobody moved to throw her out, she asked, "What do you think about that?"
Visibly embarrassed, Perry replied, "Expand Texas health care. I gotcha."
As he continued to speak, a man rose and demanded Medicaid expansion. "You leave here," Perry offered, "I'll invite you to the Capitol and we can have a face-to-face debate. Your manners will be greatly appreciated."
Texas has the highest rate of uninsured in the nation, with about 6.2 million of its residents lacking health care coverage. Advocates say extending Medicaid as directed by federal health care reform could provide up to 1 million Texans with some coverage.
But because Medicaid is a jointly funded federal-state program, Perry says embracing expansion could bankrupt Texas. He has endured such heckling before, with demonstrators even calling for Medicaid expansion during a recent speech he gave in Washington.
Wednesday's protesters were representing the Texas Organizing Project advocacy group, which has demonstrated previously outside Perry's office in the state Capitol.
When the speech was over, about 40 of them headed there -- and Perry allowed three in for a closed-door chat of about 20 minutes.
"We had a good meeting," the governor said afterward. "I don't think we came to any great epiphanies in there, but we actually found that there was a lot of things that we agreed on. Medicaid's broken."
Connie Parades, a volunteer with the Texas Organizing Project and one of the trio that met with Perry, said what they actually reached consensus on was that the U.S. health care system as a whole is deeply flawed. She also said Perry insisted Texas doesn't have the money to expand Medicaid coverage, and that she told him funding is there -- it's just being spent on other priorities like tax cuts.
"He's an agreeable person, he's a politician so he's going to be nice," Paredes said. She said her group will continue its protests.
The scene outside the governor's office was awkward but not as tense as during Perry's speech. Some of the demonstrators wore green T-shirts with their group's logos, others dressed in business attire to blend in with the rest of the crowd at the forum.
"You can't have expanded health care in this state, you can't have expanded education in this state, unless you get the economic development right first," Perry told the crowd after repeated interruptions.
When the heckling continued, Perry finally clapped his hands in exasperation and said "Please, please, please, please!" That prompted a chant in Spanish of "Health Care's not for sale!"
As he neared the end of his remarks, Perry quipped, "Only five more days until the Legislature leaves. They have the opportunity to leave in five days, let me put it that way."
That was a reference to the Legislative session which ends Monday -- unless Perry calls lawmakers back to work on specific issues. State legislators, however, have also fiercely opposed Medicaid expansion, with the House even attaching an amendment to an unrelated bill that bars any governor or state official from authorizing Medicaid expansion without a vote in the Legislature.
Lucy Nashed, a Perry spokeswoman, said he likes to meet with constituents occasionally "because he doesn't forget he's governor for them and he was sent here to represent them."
"Obviously they feel very strongly about expanding Medicaid," Nashed said. "He feels very strongly about not expanding Medicaid. He's laid out why, and I think the majority of lawmakers agree with him."
Take ABC13 with you!
Download our free apps for iPhone, iPad and Android devices