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Future of Texas Medicaid waiver remains uncertain

The future of a Medicaid waiver that reimburses Texas hospitals for providing care to uninsured...
The future of a Medicaid waiver that reimburses Texas hospitals for providing care to uninsured patients remains uncertain.(KSWO)
Updated: May. 17, 2021 at 9:40 PM CDT
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KILLEEN, Texas (KWTX) - Texas Attorney General Ken Paxton sued the Biden administration late last week to reinstate a Medicaid waiver agreement the state reached in the final days of the Trump administration.

Previously, the Trump administration had extended Texas’ Medicaid 1115 waiver through 2030.

Texas uses the Medicaid waiver, in part, to reimburse hospitals that provide care to uninsured Texans, rather than insuring Texans through an expanded Medicaid system.

It is one of 12 states that has not expanded its Medicaid coverage.

Last month, the Biden administration rescinded the waiver agreement because Texas did not allow for a 30-day period in which the public could comment on the agreement.

“The law requires you to let Texans have a say in what you’re going to put forward to the federal government,” Patrick Bresette, the executive director of Children’s Defense Fund-Texas, told KWTX.

In his lawsuit, however, Paxton asserted that the Biden administration is motivated by politics and attempting to “coerce” Texas into expanding Medicaid.

The current waiver remains in effect through September 2022.

Over the next year, Texas officials will likely have to negotiate the terms of a new waiver agreement with federal officials.

“I think Texas will get an extension,” Joan Alker, the executive director of Georgetown University’s Center for Children and Families, told KWTX.

“The question is for what and how much money is going to be included in that,” she said.

“We have to always remember that the original waiver was always meant to be a bridge between covering uncompensated care costs and helping the state have time to develop a plan for getting more low-income people covered by Medicaid,” Bresette said.

This legislative session, state lawmakers proposed Senate Bill 117, which would increase the number of people in Texas covered by Medicaid.

It did not receive a hearing in the House or Senate.

“There was a majority of the House — so enough Republicans, along with the Democrats — that would’ve passed that bill had it been given a hearing and gone to the House floor.”

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