Medicaid Waiver Extension Request Should Include Physicians, Uninsured Coverage, TMA Testifies to HHSC
By Joey Berlin


Facing the loss of crucial uncompensated care funding, the Texas Medical Association is helping the state craft a request to the Biden administration to reinstate an extension on Texas’ Medicaid 1115 Transformation Waiver.


And that request should include physicians in the safety net plan, Gary Floyd, MD, TMA’s president-elect for 2022-23, testified at a recent hearing.

In April, the Centers for Medicare & Medicaid Services (CMS) rescinded the Lone Star State’s 10-year waiver extension citing a lack of sufficient opportunity for public comment. Without an extension, the state will lose billions in safety-net funding for hospitals and health systems when the waiver expires in September 2022.

In May, the Texas Health and Human Services Commission (HHSC) published a draft of its renewed application for extending the waiver, and the agency took comments at a public hearing earlier this month.

Dr. Floyd told the commission the funding has benefited countless low-income Texans and the safety-net systems they need to receive health care.

However, he also testified that the basic construct of the waiver is a decade old, and if Texas receives long-term approval, it should foster a more inclusive and holistic health care system. Medicine also wants the waiver to provide financial protection for the state’s entire health care safety net, which includes community physicians – not just hospitals, public health departments, and mental health practitioners.

Dr. Floyd told HHSC that medicine supports:

  • Offsetting the cost of uncompensated care provided by safety-net entities and amending the waiver to ensure financial viability for all components of the safety-net system – including allowing the redirection of funds to physicians and community clinics;
  • Seeking the authority to establish a comprehensive health coverage initiative tailored to Texas to reduce the state’s alarming uninsured rate among adults of working age; and
  • Promoting an inclusive, holistic, and community-driven approach to improving population health and health outcomes. That includes piloting organized medicine’s vision for an accountable health organization governed by a community-based board of physicians, hospitals, safety-net entities, and others to develop a shared vision of health for the community and implement value-based care.

HHSC’s request to CMS, as drafted, asks to extend the waiver through Sept. 30, 2030.

Last Updated On

June 15, 2021

Originally Published On

June 14, 2021