The Biden administration Friday rescinded an approved extension of the Medicaid agreement in Texas, which has the nation’s most uninsured residents and for years has refused calls to expand the federal health insurance program.
Texas is one of only 12 states that have resisted expanding coverage under a key provision of former President Barack Obama’s health care law. Instead, state Republican leaders have negotiated waivers that provide billions of federal dollars in reimbursements to hospitals that serve the uninsured.
Texas’ current waiver expires in 2022.
The Biden administration has tried to financially incentivize GOP holdouts to opt into expansion, but none have indicated plans to change course.
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Texas’ waiver had been approved through 2030 under an agreement worked out with the Trump administration. But in a letter to Texas officials Friday, the Centers for Medicare and Medicaid Services said the agency previously “erred” because the approval that took place during the coronavirus pandemic did not include the normal opportunity for public notice and comment.
Republican Gov. Greg Abbott blasted the decision that he said had followed months of negotiations with federal officials.
“With this action, the Biden administration is deliberately betraying Texans who depend on the resources made possible through this waiver,” Abbott said.
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In a statement, the Centers for Medicare and Medicaid Services pressed the importance of public comment, saying “stakeholder feedback forms the backbone of programs that help achieve the best possible results for beneficiaries.”
Texas received its first Medicaid waiver a decade ago, and GOP leaders have resisted calls to opt into expanding Medicaid since then.
In Texas, the incentives for expansion would send the state about $5 billion over two years, and the state’s share of expanding coverage would be about $3.1 billion. More than 1.4 million people in the state could become eligible for coverage.