Bipartisan Solution Waiting in Capitol Wings
as Abbott Falsely Portrays Medicaid Ruling

Capitol Inside
April 17, 2021

The Texas House has a bipartisan move under way that would save the state $15 billion or more in the next year alone by giving Republican lawmakers the opportunity to boost the number of people with health insurance here without having to call the move an official expansion of Medicaid.

All of the lower chamber's 67 Democrats and seven GOP colleagues have signed on as co-sponsors of a bill that State Rep. Julie Johnson of Dallas has authored in a bid to have the state seek a federal waiver for a Live Well Texas program in lieu of the more traditional Medicaid expansion under the Affordable Care Act.

Democratic President Joe Biden's administration threw a major curve into the Texas Republicans' state budget plans with a decision on Friday to reverse Donald Trump's promise of a 10-year extension for the Texas Medicaid expansion waiver.

Governor Greg Abbott mischaracterized the decision by the Centers for Medicare and Medicaid Services - contending that the federal agency had cancelled the Texas waiver in an attempt to hurt the elderly and poor people in the Lone Star State. The current waiver actually will remain in effect until it expires next year in September.

“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,” Abbott said in a statement late Friday. “The State of Texas spent months negotiating this agreement with the federal government to ensure vital funds for hospitals, nursing homes, and mental health resources for Texans who are uninsured. With this action, the Biden administration is deliberately betraying Texans who depend on the resources made possible through this waiver.”

Abbott failed to point out that Republicans here should be blaming Trump for having his lameduck administration rush through a review of the Texas waiver extension application in time for him to announce it five days before he left office on January 20. CMS Acting Administrator Liz Richter informed the Texas Health & Human Services Commission in an 82 page letter that the fast-track approval process that the Trump administration had used been fundamentally flawed.

Trump at the time had been frantically searching for ways to distract from the riot at the U.S. Capitol two weeks earlier when his supporters killed a police officer and four others in an attempt to disrupt the congressional ceritification of Biden's victory in November. Trump apparently thought he could bolster his odds for a third straight win in Texas in a potential comeback race by cutting corners on the waiver extension request.

The Texas Legislature is meeting for the first time during a major global pandemic in more than 100 years. But neither Abbott or Lieutenant Governor Dan Patrick had made health care a priority this year. The state's two highest-ranking leaders have focused primarily on conservative theme proposals that are designed exclusively for partisan gain with both planning to seek re-election in 2022.

With the state standing to lose $11 billion a year in federal funding on top of nearly $4 billion more in stimulus allocations without the waiver in effect, GOP Speaker Dade Phelan has a chance to take the lead now in a real emergency with Johnson's Live Well Texas proposal in House Bill 3871.

House Democrats are united by HB 3871 - a measure that advocates believe the Biden administration as a substitution for the waiver that expires next year. Republican State Reps. Steve Allison of San Antonio, Kyle Kacal of College Station, Dan Huberty of Humble and Lyle Larson of San Antonio was listed as co-authors on the Johnson measure. Johnson also has enlisted GOP State Reps. Ernest Bailes of Shepherd, Travis Clardy of Nacogdoches, Stan Lambert of Abilene as co-sponsors on HB 3871.

Johnson discussed the legislation with Phelan this week in apparent anticipation of the invalidation of the flawed Trump approval process that led Abbott and the other Republicans here to believe that they could avoid an expansion of Medicaid for at least another 10 years.

Democratic State Senator Nathan Johnson of Dallas is sponsoring an identical bill across the rotunda with Democratic State Senators Juan "Chuy" Hinojosa of McAllen and Borris Miles of Houston as co-sponsors.

Lawmakers don't have the luxury of putting a decision on Medicaid off until a special session in light of the fact that it could take up to a year to negotiate a new waiver.

Abbott and the Republicans have offered no viable reasons for refusing to expand Medicaid for years in moves that already have cost the states billions of dollars. GOP leaders here have been content to sacrifice the money for the political mileage they think they get with their opposition to Obamacare.