Congressional Democrats ask HHS to restore funding for Texas hospitals

By Bethany Blankley | The Center Square

Eleven Texas Congressional Democrats have called on the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to restore about $10 billion in funding to Texas hospitals.

In a letter to HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, the Democrats urge the administration to restore funding that is “critical to protecting our most vulnerable Texans and to preserving our safety net.”

The 11 members of Congress who sent the letter included Collin Allred, Joaquin Castro, Henry Cuellar, Veronica Escobar, Lizzie Fletcher, Al Green, Vincente Gonzalez, Sheila Jackson Lee, Eddie Bernice Johnson, Marc Veasey, and Filemon Vela, who called on the administration last month to restore funding.

Vera also asked the administration to come up with an immediate, short-term solution since “further delays threaten the stability of the existing safety net.”

The Medicaid 1115 waiver program, part of the Social Security Act, allows states to test new or existing ways to deliver and pay for health care services in Medicaid and the Children’s Health Insurance Program (CHIP).

Not long after President Joe Biden took office, his administration rescinded the waiver because of a procedural issue with the paperwork. Liz Richter, acting administrator for CMS, wrote in an April 15 letter to Texas officials its approval was rescinded because “it did not go through the full federal rulemaking process.” Texas rejected the claim.

The extension, which was scheduled to run through 2030, would have provided $11 billion per year in health care funding to Texas, including for uncompensated care.

Texas Attorney General Ken Paxton sued in response, arguing, “The Biden Administration cannot simply breach a contract and topple Texas’s Medicaid system without warning. This disgusting and unlawful abuse of power aimed at sovereign states must end.”

U.S. District Judge J. Campbell Barker sided with Texas in August, directing the funding to be restored.

CMS approved last month two of five directed payment programs (DPPs), which had been the subject of negotiations between Texas and CMS. The congressional delegation is asking for all of the programs to be restored.

At issue is funding the Local Provider Participation Funds (LPPFs), which “are a vital part of our health care safety net in Texas, particularly in areas of the state, such as the southern border region and the 89 Texas counties where Medicaid patients are primarily served by non-governmental hospitals, where Medicaid beneficiaries already have limited access to care,” the lawmakers wrote.

David Balat, who leads health care initiatives at the Texas Public Policy Foundation, told The Center Square, “It’s clear from the actions of CMS that it is more important to them to expand Medicaid to able-bodied adults than it is to fund important safety net programs aimed at women and children. Medicaid was created to protect these populations and we need to do what we can to improve the current Medicaid program, not suffocate existing programs in favor of political ideology.”

Rejecting the waiver was seen as an attempt to push Texas into participating in the federal government’s oversight of the Affordable Care Act’s Medicaid expansion, a move Texas continues to reject.

The Washington Post reported earlier this year the administration already had forced a dozen holdout states to accept Medicaid expansion by rescinding funding or through other measures. If Texas were to participate, it would receive $3.9 billion in funding over two years and more than two million uninsured individuals would be eligible to receive Medicaid coverage, the Post reported.

Paxton described Biden’s “attempt to force our state into expanding Medicaid – the Biden Administration’s ultimate goal” – as “deplorable” and “illegal.”

The Democratic delegation said it wholeheartedly supports Medicaid expansion, but until that happens, they asked for the funding to be restored, which is “critical to protecting our most vulnerable Texans and to preserving our safety net.”

The Texas Indigent Healthcare Association and the Texas Essential Healthcare Partnerships (TEHP) also sent a letter to CMS, arguing Texas’ “indigent care programs rely on the viability of our local safety net hospitals. Right now, our communities are feeling pressure from the decision not to approve three Medicaid managed care directed payment programs.” They said they were hopeful CMS would approve the programs before the end of the year.

“Countless Texans are currently at risk of losing vital healthcare services due to the stalemate over the 1115 waiver,” TEHP President Don Lee said in a statement. “Those who are uninsured and underinsured cannot afford to be without these essential healthcare programs and TEHP is grateful to have allies in its effort to restore this funding immediately.”