Biden administration rescinds Medicaid waiver for care of uninsured in Texas
The extension — worth billions of dollars a year — was voided due to a lack of public notice process required for all such waivers.
The Biden administration has rescinded changes to an agreement with Texas that would have extended a safety net for the uninsured for a decade. The Washington Post reported that the decision was an attempt to encourage the state to expand Medicaid.
“The waiver extension would have helped the state to seamlessly continue support for much-needed health care improvements and would have continued stable funding for hospitals that serve large numbers of uninsured patients,” said Ted Shaw, president of the Texas Hospital Association.
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The Centers for Medicare and Medicaid Services said it mistakenly exempted Texas from normal public notice process before granting an extension to the 1115 waiver in the waning days of the Trump administration. The agency “has rescinded the extension approval, which corrects this oversight with as little impact as possible to the people of Texas, since the original demonstration remains intact through September 30, 2022,” it said in a statement.
The waiver reimburses hospitals for the uncompensated care they provide to patients without health insurance and pays for innovative health care projects that serve low-income Texans, often for mental health services. The extension — worth billions of dollars a year — would have continued hospital reimbursements until September 2030 but allowed the innovation fund to expire this year.
The state’s first 1115 waiver was approved in 2011. It was meant to be a bridge to Medicaid expansion under the newly passed Affordable Care Act, but a subsequent U.S. Supreme Court ruling gutted the Medicaid expansion part of the sweeping federal health law.
Republican state officials slammed the decision. “The state of Texas spent months negotiating this agreement with the federal government to ensure vital funds for hospitals, nursing homes and mental health resources for Texans who are uninsured,” Gov. Greg Abbott said.
The president of the nonprofit Texas Essential Healthcare Partnerships said the loss of funding would “create a cascading disaster as hospitals failed and Texans had no or limited access to hospital services.”
The announcement comes as some health care advocates and state lawmakers are pushing to broaden Medicaid coverage, although bills to do so far have failed to pass either chamber. Patrick Bresette, head of the Children’s Defense Fund, said “the waiver was always intended to serve as a temporary bridge until the state implemented a coverage option — with federal Medicaid expansion funds — for low-wage workers whose jobs don’t provide health insurance.”
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