The Obama administration looks to be taking its Medicaid hardball tactics to Texas.
The Centers for Medicare and Medicaid Services indicated to Texas officials Thursday that whether the state expands Medicaid under the Affordable Care Act would factor into the renewal of a multibillion-dollar Medicaid funding stream next year, according to state officials.
Federal officials requested a call with the Texas Health and Human Services Commission, during which they outlined their position, Linda Edwards Gockel, a spokeswoman for the Texas health agency, said in an email to National Journal.
The call came the same day that Florida Gov. Rick Scott said he would sue the Obama administration, accusing CMS of pushing the state to expand Medicaid by leveraging $1 billion in federal Medicaid funding, which is up for renewal this summer and helps cover some uncompensated care.
CMS said in a letter to Florida this week that one of the three principles it would use to evaluate the program, known as the Low-Income Pool, was that “uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion.”
In the phone call with Texas officials, “CMS 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. “We don’t have more details than that at this point.”
A CMS spokesman confirmed that the agency would use the principles outlined in the Florida letter, which include a state’s Medicaid expansion status, when reviewing uncompensated-care funding pools in other states like Texas.
“We will also use these principles in considering similar proposals in other states,” CMS spokesman Aaron Albright said in an email, “but discussions with each state will also take into account state specific circumstances.”
Texas’s uncompensated-care funding pool, part of a broader Medicaid waiver, is coming up for renewal in September 2016. According to the Texas Hospital Association, the program provides more than $3 billion to Texas hospitals for uncompensated care.
The Lone Star State is the biggest state not to expand Medicaid under Obamacare; about 950,000 low-income Texans would receive health coverage if the state did accept the expansion.