Andy Miller, MHSE
Chief Strategy and Impact Officer
Texas Health Institute

As you have likely heard by now, Texas will be refiling with the Centers for Medicare and Medicaid Services (CMS) a request to extend the uncompensated care pool part of the Medicaid 1115 waiver for 10 years after the previously approved waiver was rescinded in April. This request will seek billions of dollars to continue reimbursing hospitals that incur costs due to uninsured patients, many utilizing emergency rooms for non-emergency conditions as they are required by law to treat anyone who presents for care. It has long been established that using the emergency room as the primary mechanism for providing health care is expensive, inefficient, and fails to enable people to get preventive services, medications, and effectively manage their chronic conditions.

Alternatively, expanding health insurance coverage in addition to adequate funding for safety net providers to cover uncompensated care costs for those who are not eligible for affordable insurance coverage could lead to both improved health outcomes for Texans and reduced costs to over time.

The state is holding a public comment period for stakeholder input before sending the application to CMS, which will then hold a second, federal public comment period prior to issuing its decision. CMS specifically cited the lack of a public comment period as its reasoning for rescinding Texas’s previous waiver extension. It is critical that Texans make their voices heard on this issue. The deadline to submit written comments is June 28, 2021.

For more information and to submit written comment, please visit the Texas HHS website.