Paxton lawsuit targets Medicaid waiver
Texas Attorney General Ken Paxton is suing the Biden administration over its decision to rescind a Medicaid waiver extension that would ensure billions in emergency care funding to the state’s hospitals over several years.
Federal health officials revoked the extension in April, saying the Trump administration, which had approved it in its waning days, failed to allow for public comment. They have welcomed the state to reapply before the current waiver lapses in the fall of 2022.
In a suit filed Friday, Paxton argued that the officials lacked authority to overturn the decision and said the state and its health care providers had already made long-term financial decisions based on the approval.
“Not only does this violate agency regulations and threaten to rip a $30 billion hole in Texas’s budget, it was clearly intended to force our state into inefficiently expanding Medicaid under the Patient Protection and Affordable Care Act,” Paxton said in a statement. “This would be a disaster for our state, and yet President Biden seems intent on thrusting his bloated model of government on everyone — including Texas.”
Federal health officials did not immediately respond to a request for comment on the litigation.
The administration’s reversal was widely seen as an attempt to pressure the state into expanding Medicaid under the ACA, a move most other states have made since the law passed in 2010.
Republican leaders have declined numerous proposals to expand the safety net coverage, including in the current legislative session, explaining they are focused on other health care priorities.
Lawmakers in the House voted down an amendment this week to even study the potential benefits of Medicaid expansion. The Senate has yet to hold preliminary hearings on smaller measures passed by the House and aimed at improving access for new moms and kids.
Proponents of expansion say it will lower hospital and county expenses, boost the state’s economy and create access to preventive care for up to a million low-income Texans. The state has the highest uninsured rate in the country.
The waiver in question has been used for years to shore up the cost of providing emergency care in hospitals to the millions of Texans who are currently uninsured. The decision to circumvent the public comment period last year was ostensibly because of the pandemic, a reason that health advocates have questioned given the current waiver was still in place nearly two years.
In an exchange earlier this week with U.S. Rep. Dan Crenshaw of Texas, Health Secretary Xavier Becerra said officials remain committed to working with the state on a new extension.
“We’re trying to make sure that we’re transparent and we show accountability, because we have to make sure we’re following the law,” he said. “And we’re working with your leadership in the state and along with your delegation, try to make sure that as Texas moves forward, if it wants to continue the waiver, we’re going to be working with you to make sure we can see that happen.
Health care advocates called the suit ironic since Paxton, a Trump-aligned Republican, has been fighting for years to overturn the ACA, which has resulted in coverage for millions of previously uninsured Americans.
“It’s just way more evidence of how out of touch our leadership is with what people actually want,” said Patrick Bressette, who heads the Children’s Defense Fund of Texas.
In surveys, most Texans support expanding Medicaid.
“This signals to me the misplaced priorities,” Bressette said. “They’re spending resources fighting the administration instead of working on bipartisan solutions that Texans want.”