It’s constitutional – deal with it
The federal government is officially holding state leaders’ feet to the fire, hoping to get Texas to expand its Medicaid program to provide health insurance to more low-income Texans.
Federal officials called the state’s health agency this week to say that Texas’ reluctance to expand Medicaid — a key tenet of President Obama’s signature health law — will play into whether his administration extends a waiver that helps the state’s hospitals cover uninsured patients.
The development follows news from Florida, where a similar tug-of-war is playing out between the federal government and a Republican-controlled statehouse that opposes Obamacare but hopes to renew billions of dollars in hospital funding. This week, federal officials sent a letter to Florida lawmakers that said Medicaid expansion “would reduce uncompensated care in the state,” making it “an important consideration in our approach regarding extending” the state’s hospital waiver.
Linda Edwards Gockel, a spokeswoman with the Texas Health and Human Services Commission, confirmed Friday that federal health officials called the Texas agency Thursday afternoon to relay a similar message.
Officials from the federal Centers for Medicare and Medicaid Services “said they recognize each state is different, but they intend to use the same three principles outlined in their letter to Florida as they evaluate uncompensated care funding pools in all states,” Edwards Gockel said in an email. “We don’t have more details than that at this point.”
Tom Banning, chief executive of the Texas Academy of Family Physicians and an advocate for Medicaid expansion, said in an email that the call “should be a wake up.” Annually, Texas hospitals receive billions of dollars combined by way of the federal “transformation waiver.” Losing that money “will have a crippling effect throughout Texas,” Banning added.
The Texas hospitals waiver runs through September 2016, but the 2015 legislative session is the last chance for state lawmakers to negotiate a renewal before then. The current session is slated to wrap up on June 1, barring a governor-called special session.
Estimates for the value of that waiver vary. The Texas Hospital Association, which supports some form of Medicaid coverage expansion under the Affordable Care Act, estimates the waiver’s five-year value at $29 billion.
See here for the background. As noted in the story, the feds are similarly putting the screws to Florida. There’s basically zero chance that anything will get passed this session – Sen. Rodney Ellis tried to get a Medicaid expansion amendment through during the budget debate and failed, while Greg Abbott is holding firm and whining about how mean the feds are being to him – so it’s just a matter of whether the feds follow through in 2016 and if enough pressure can be brought to change things in 2017. Anyone want to place a bet on that? The only semi-retired Burka has more.
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