87th LegislatureFederalHealthcareState HouseTexas House Democrats Call for Restoration of Medicaid Waiver

The Biden administration's maneuver aimed at forcing Texas' hand toward Medicaid expansion is losing support as a court case drags and bills pile up.
January 24, 2022
The Texas House Democratic Caucus (HDC) has thrown in the towel on a stand-off between the State of Texas and the Biden administration over a Medicaid program.

Back in April last year, the Centers for Medicare & Medicaid Services (CMS) retroactively denied Texas’ application for renewal of its Section 1115 Medicaid waiver after it had already been approved during the Trump administration. The waiver enables the state and hospitals within it to receive federal reimbursements for certain categories of uncompensated care.

It is estimated to be worth $30 billion in federal aid.

Medicaid, one of the nation’s largest welfare programs, pays health care costs for millions of low-income people across the country who do not otherwise have insurance.

But after a prolonged back and forth, the HDC has called for the federal government to restore the waiver until the legislature meets again in 2023.

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“We urge you to immediately reinstate the suspended payments to the Texas Medicaid program, and, at the same time, work with Texas to put in place a plan for next steps and a path forward that will increase health care access and coverage while recognizing our state’s need for a sustainable and robust health care delivery system, (Direct Payment Programs), and a continued Medicaid 1115 waiver,” the letter from the caucus reads.

“We are strong supporters and allies with you in efforts to increase health care coverage and access in Texas and decrease the number of our state’s uninsured.”

They are not the first Texas Democrats to reverse course on the waiver. In December, four Democratic congressmen called for the waiver’s restoration, citing the lost funds for uncompensated care.

Democrats in Texas approved of the administration’s decision last year, including the HDC which welcomed it as a catalyst for Medicaid expansion.

“We again have the opportunity to get a permanent solution by working with the Biden Administration and CMS to get the coverage expansion for Texans under the Affordable Care Act,” Rep. Garnet Coleman (D-Houston) said on behalf of the caucus.

Shortly thereafter, the Office of the Attorney General sued the Biden CMS and was delivered a victory in the form of a preliminary injunction in August.

Since it first became an option nearly a decade ago, the Texas legislature has continuously rejected Medicaid expansion that would increase the eligibility criteria.

Last year, Medicaid expansion gained the support of nine Republican House members, all but one of which ultimately abandoned the maneuver when push came to shove.

The case’s final ruling is still pending in the U.S. District Court for the Eastern District of Texas.


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Brad Johnson

Brad Johnson is a senior reporter for The Texan and an Ohio native who graduated from the University of Cincinnati in 2017. He is an avid sports fan who most enjoys watching his favorite teams continue their title drought throughout his cognizant lifetime. In his free time, you may find Brad quoting Monty Python productions and trying to calculate the airspeed velocity of an unladen swallow.