XPost: or.politics, ca.politics, alt.politics.trump   
   XPost: alt.fan.rush-limbaugh, seattle.politics   
   From: benders@bloody.invalid   
      
    reuters.com   
   Texas sues Biden administration over loss of Medicaid waiver   
   Brendan Pierson   
      
   Texas Attorney General Ken Paxton in Washington, U.S. June 9, 2016.   
   REUTERS/Jonathan Ernst   
      
   Texas has sued President Joe Biden's administration over its decision   
   to rescind the previous administration's approval of changes to its   
   Medicaid program, saying the move was meant to pressure the state into   
   expanding Medicaid under the Affordable Care Act.   
      
   In a complaint filed Friday in federal court in Tyler, Texas, the   
   state said that the loss of the approval could cost the state more   
   than $30 billion and would have an "almost incalculable effect on   
   Texas' most vulnerable citizens."   
      
   "The Biden administration cannot simply breach a contract and topple   
   Texas' Medicaid system without warning," Texas Attorney General Ken   
   Paxton said in a statement. "This disgusting and unlawful abuse of   
   power aimed at sovereign states must end."   
      
   The U.S. Centers for Medicare and Medicaid Services (CMS), the agency   
   within the Department of Health and Human Services that administers   
   Medicaid, had no immediate comment.   
      
   The dispute centers on a so-called Medicaid waiver first granted to   
   Texas in 2011. CMS can provide waivers to states wishing to depart   
   from usual federal rules for administering Medicaid, a joint federal   
   and state program meant to cover low-income and disabled people.   
      
   Texas' waiver, which has been modified several times, allows the state   
   to require Medicaid recipients to enroll in managed care organizations   
   (MCOs), which are intended to reduce costs. Under a managed care   
   model, Medicaid pays MCOs a fixed premium for each beneficiary, rather   
   than paying for services directly.   
      
   Texas also receives federal funding for a related incentive program   
   through which bonuses are distributed to Medicaid providers or regions   
   based on improvement metrics. About $20 billion has been distributed   
   through that program, according to the lawsuit, but federal support   
   for the program is set to expire this September.   
      
   In 2020, the state sought an extension of the waiver, set to expire in   
   2022, through 2030. It was allowed to bypass the normal notice and   
   comment period in light of the COVID-19 emergency.   
      
   The newly extended program included new federal funding to replace the   
   expiring incentive program, according to the lawsuit. In April,   
   however, CMS informed Texas that the extension had been improperly   
   granted because there had been no notice and comment period.   
      
   The state said in the lawsuit that the sudden rescission violated   
   federal law.   
      
   "Federal authorities may not topple a state's Medicaid system as a   
   child might a sandcastle," it said.   
      
   The state also said that the decision had an "ulterior motive," noting   
   that CMS had cited a letter from three advocacy groups - Children's   
   Defense Fund-Texas, Every Texan and Texans Care for Children - that   
   criticized the state for relying on its waiver program rather than   
   expanding Medicaid under the ACA.   
      
   The organizations said in their letter that despite "valuable   
   contributions" of the waiver, "Texans need and deserve more."   
      
   The state is seeking a court order that the April rescission is   
   invalid.   
      
   Texas is one several Republican-led states that have not taken   
   advantage of expanded Medicaid funds through the ACA, the signature   
   achievement of Democratic former president Barack Obama.   
      
   The case is State of Texas et al v. Richter et al, U.S. District   
   Court, Eastern District of Texas, No. 21-cv-00191.   
      
      
      
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