The Biden administration has revoked a federal waiver that provided federal funding to Texas even though Republican officials in the state have refused to expand Medicaid as provided for by the Affordable Care Act, otherwise known as Obamacare. The Trump era waiver provided billions of dollars to Texas including support for “uncompensated care,” meaning that officials were reimbursing hospitals for care provided to patients who didn’t have insurance.
The formal notice of the waiver revocation from federal officials at the Centers for Medicaid and Medicare Services (CMS) cited the Trump team’s failure to abide by requirements for a public comment period as reason for the waiver’s termination. The waiver was approved just this past January, during the Trump administration’s final weeks in office, and no period for public comment on the matter preceded its implementation.
Enabling Texas’s refusal to expand Medicaid could be destructive, because instead of providing assurance to beneficiaries that they’ll have some form of health coverage if needed, some disadvantaged Texans who could be helped by expanding the program have to just wait and see while facing potentially life-threatening problems. An assurance of coverage could equate to openness to seeking care. Meanwhile, a CMS spokesperson commented as follows:
‘CMS remains committed to working with states—as it always has—on solutions that can meet the public’s expectations for transparency while strengthening Medicaid’s aims.’
Texas Republican Governor Greg Abbott complained that “the Biden administration is obstructing healthcare access for vulnerable Texans and taking away crucial resources for rural hospitals in Texas” — although Republicans in Texas are standing in the way of expanding Medicaid in their state. As Georgetown University Medicaid expert Joan Alker put it, “A lot of these people don’t need to be uninsured anymore now that the state can do Medicaid expansion.” According to an analysis from the Kaiser Family Foundation, over 700,000 Texans could gain health coverage if Texas authorities expanded Medicaid in their state, but they just won’t do it — and somehow, Abbott is singling out Biden’s team for criticism instead of employing meaningful self-reflection.
The Biden administration has also revoked federal waivers that allowed for the implementation of work requirements for Medicaid recipients in certain states like Michigan and Wisconsin. In the Michigan case, acting CMS chief Elizabeth Richter wrote that “such a requirement risks rapid coverage loss” among beneficiaries, although no one had lost coverage — yet — because of the requirement.
Trump era CMS Administrator Seema Verma claimed that a work requirement would help people become self-sufficient, as though an order from the government is what most unemployed or otherwise financially struggling people are waiting for before becoming financially stable. Obviously, that’s not the case. Pretending like just about every case of poverty could be solved by just deciding to go get a job is ridiculous and just ignorant. What about starvation wages? What about economic downturns? What about sudden huge expenses, like health crises? The list goes on.
