A new sense of urgency for Texas to expand Medicaid


Texas is one of just twelve states that has not expanded Medicaid. Now, the question of whether or not the state will expand Medicaid has gotten more urgent with the repeal of a Trump-era waiver.

According to a document seen by the Washington Post, the Biden administration informed Texas that it would be rescinding a 10-year extension of the Texas Medicaid plan that was approved in the final days of the Trump presidency. The waiver was issued by the former Administrator of the Centers of Medicare and Medicaid Services Seema Verma on January 15. The health administrator argued that the waiver could be issued haste and without public comment in spite of existing federal transparency guidelines because of the COVID-19 pandemic. 

Gov. Greg Abbott issued a blistering statement blasting the Biden administration for rescinding the waiver. “By rescinding this waiver extension, the Biden administration is obstructing healthcare access for vulnerable Texans and taking away crucial resources for rural hospitals in Texas,” said Abbott. On Twitter, John Cornyn also referred to the move from the Biden administration as “a low blow.”

In light of the Biden administration’s ruling that the waiver for Texas was issued without going through a full federal review, several prominent Texas Democrats pointed out that the state could simply expand Medicaid. U.S. Rep. Joaquin Castro also noted that federal waivers for uncompensated care “are not a permanent solution.”

When Texas refused to expand Medicaid in 2011 under the Affordable Care Act, it left billions of federal funds on the table. Currently, Texas leads the country in the number of uninsured, with about 1 in 5 Texans lacking healthcare. That number has likely even gone up in the past year with the COVID-19 pandemic.

The Washington Post also viewed a presentation from officials with the Biden administration that showed if Texas were to expand Medicaid, the state would receive over $3.9 billion in federal funds. Over 2 million Texans would also qualify for coverage under Medicaid.

Currently, there is legislation filed to expand Medicaid in Texas. There is even a vocal Republican state legislator, Rep. Lyle Larson, who wrote an op-ed in The Austin American-Statesman about how expanding Medicaid coverage makes economic sense.

It’s doubtful that Abbott, or other Republican statewide officials are going to change their mind regarding regarding Medicaid expansion. Right now, the state legislature is focused on other legislation like draconian abortion laws and ensuring transgender athletes cannot compete in a sports league that matches their identity.

State Rep. Donna Howard made the point on Twitter, that the state of Texas can re-apply for the waiver and that federal funding isn’t abruptly halted. However, she also indicated that the Texas legislature could “do what we’re supposed to do: expand Medicaid.”

Howard tagged state Senator Nathan Johnson in her post. Johnson is the author of SB 117, also known as the Live Well Texas Program, which would expand Medicaid in Texas.

Photo: Carl Court/Getty Images

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