(The Center Square) – A bipartisan group of Texas senators is calling on the Biden administration to stop its repeated attempt to defund Medicaid payments to the poorest and most vulnerable Texans. They did so after Attorney General Ken Paxton sued the administration in April for its second attempt to defund Medicaid after having already received an injunction halting the first attempt in 2021.
In a news conference, the senators argued the federal government is attempting to coerce Texas to expand Medicaid through the Affordable Care Act by banning how Texas funds hospitals and healthcare facilities primarily in rural and low income areas.
At issue is the Local Provider Participation Funds (LPPF) program, through which municipalities and local governments levy and collect mandatory assessments from health-care providers and private hospitals to help pay for uncompensated care. The money collected is transferred to the state to help finance its share of Medicaid.
Texas’ Medicaid program is jointly funded by the state and federal government. Since 2013, and with the U.S. Department of Health and Human Services’ Center for Medicare and Medicaid Services’ (CMS) authorization, Texas has allowed local governments to administer LPPFs. CMS attempted to rescind its authorization of LPPFs in 2021 but Paxton sued, arguing the plan would short Texas out of $11 billion in Medicaid funding. Texas’ Congressional Democrats also called on CMS to reverse course. It did but only after a federal judge issued an injunction, leaving LPPFs in place.
In another attempt to remove LLPFs, CMS is now categorizing private contracts involving entities that pay taxes into LPPFs as hold harmless arrangements, which are prohibited by federal law. Hold harmless arrangements are made between governments and health care providers guaranteeing that providers receive total tax payments back through Medicaid payments.
Such arrangements aren’t occurring in Texas and the Texas Health and Human Services Commission doesn’t have the authority to authorize them. However, CMS says it plans to require HHSC to provide it with “hold harmless arrangements” information – information it says it doesn’t have – as a condition to receive the federal portion of Medicaid funding.
This attempt, Texas lawmakers argue, would short Texas out of nearly $8 billion.
“The federal government, through CMS, is trying to find a way to pressure the state of Texas and other states to expand Medicaid,” Sen. Juan “Chuy” Hinojosa, D-McAllenm, said at a recent news conference at the state capitol. “Unfortunately, the approach they’re taking is very damaging, has a very negative impact on our safety net hospitals and the people that we represent.”
Sen. John Whitmire, D-Houston, who like Hinojosa argues Texas should voluntarily expand Medicaid, said he shared the “frustration” the Biden administration has that Texas hasn’t expanded Medicaid. But, “if this is a measure that you are taking to try and coerce us or force us to reconsider our Medicaid policy, don’t go down that path,” he said.
Sen. Nathan Johnson, D-Dallas, who also supports Medicaid expansion, argues CMS’ proposed changes “don’t make any sense. If we did expand Medicaid, we’d pick up about a million people.
“We have more than five million uninsured people in Texas,” he said. “The idea that you’re going to punish Texas for not expanding Medicaid takes hostage those other four million uninsured people.”
“Texas has relied on this system and built our safety net around it, and we can’t have the rug pulled out from under us,” state Sen. Bryan Hughes, R-Mineola, said.
Texas’ second lawsuit filed in April alleges CMS’s proposal “threatens the integrity of Texas’s Medicaid program and the nearly five million citizens that it serves by imposing requirements that are neither authorized by statute nor required by existing regulations.”
The lawsuit was filed in the U.S. District Court for the Eastern District of Texas Tyler Division. It names CMS and the U.S. Department of Health and Human Services and their respective administrator and secretary, respectively, as defendants.
Hughes said the lawmakers were calling on the administration to reverse course, noting that “Texas has won this issue in court before and believe that we will again, but we don’t want to wait for the courts. The administration should stop this in its tracks.”
This article First appeared in the center square