Dive Brief:
- Federal officials have reportedly warned Texas that holding out on Medicaid expansion will factor into whether the state gets a waiver extension to help it cover uninsured hospital patients.
- A similar scenario is playing out in Florida, where the governor has threatened legal action against the federal government for its attempt to manipulate the state by threatening the loss of hospital funding.
- An official in Florida said the state received a letter this week from the federal government saying that Medicaid expansion would "reduce uncompensated care in the state" and would therefore be "an important consideration in our approach regarding extending" the state's hospital waiver. A spokeswoman in Texas said state health officials there received a similar message by phone.
Dive Insight:
The news appears to confirm concerns that the federal government's actions in Florida might foreshadow moves to pressure other Medicaid expansion holdouts as well.
CMS officials "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," Linda Edwards Gockel, a spokeswoman with the Texas Health and Human Services Commission, told The Monitor via email.
The Texas hospitals waiver continues through September 2016, but state lawmakers would need to negotiate a renewal during the 2015 legislative session, which ends June 1. The waiver is estimated by the Texas Hospital Association to have a five-year value of $29 billion.
As The Monitor notes, Texas' rate of uninsured is the highest in the U.S. at about one in four.