Federal officials could be trying to tighten the funding spigot until Texas begins contributing more for indigent care, national health experts say.
set off a firestorm among hospital and patient advocates, many of whom are divided over the state’s increasing reliance on waiver dollars to compensate for the state’s bare-bones Medicaid program.
“They’re now in a game of chicken with the administration,” Sara Rosenbaum, a health law and policy professor at George Washington University, said of the state’s position.In revoking the Trump renewal, Rosenbaum said it’s possible that federal officials are trying to pressure Texas into contributing more toward indigent care. Aside from Medicaid expansion, the state also has historically low reimbursement rates for providers, including hospitals.
But Judy Solomon, who studies health policy at the progressive Center on Budget and Policy Priorities, said CMS has raised valid questions about the state’s funding mechanism. Typically, states access waiver dollars with matching funds from their general revenue or through statewide provider taxes. “This dispute really comes down to whether these payments conform to the rules that CMS administers,” Solomon said.
“This includes making sure that providers in Texas receive all Medicaid payments for providing services to Medicaid beneficiaries to which they are entitled,” it wrote.
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