Texas members of Congress demand reversal of CMS waiver rescission

In stark contrast to Democratic calls to expand Medicaid in the wake of Texas’s loss of its Medicaid 1115 waiver, the Texas Republican Congressional Delegation wrote an open letter to the U.S. Department of Health and Human Services on Tuesday asking them to reverse the Centers for Medicare and Medicaid Services (CMS)’s waiver rescission. The letter claims the rescission compromises Texas’s future plans for Medicaid funding and decreases trust between the state and CMS.

“More than four million Texans, including half of all children in the State, depend on the stability of the State’s Medicaid program for quality health care for themselves and their families. Revoking the extension of Texas’ 1115 Waiver pulls the rug out from beneath these patients and puts their health care at risk. Hospitals and providers in the State have been pushed to the brink and stretched thinner than ever before during the COVID-19 pandemic.”



All twenty-four of the state’s Republican members of Congress signed the letter, including Sens. Ted Cruz and John Cornyn.

The effort was led by Rep. Michael Burgess, who explained his support in a tweet on Wednesday:

“Rescinding TX 1115 Medicaid waiver jeopardizes billions of dollars in funding for Texas’ Medicaid program and erodes the partnership between the state and CMS.”

The letter lists the state’s plan to transition away from its Delivery System Reform Incentive Program (DSRIP) as one of the main reasons to reverse the decision:

“This waiver extension also established a transition away from [DSRIP] towards a new Public Health Provider charity care pool and directed payment programs during the COVID-19 pandemic. The State is already several months into working with CMS to establish new directed payment programs. Rescinding the waiver extension creates uncertainty for the programs that need to be operational by October 1, 2021.”

The letter also explains why the delegation believes renewing the waiver is a better solution than applying for a new one, mainly citing concerns about limited time:

“The time and effort required to renegotiate a new waiver extension will detract from the work that Texas and your agency could be conducting to improve health care for Texans and for Americans.”

Democrats and Republicans have proposed very different solutions to the loss of the waiver. While Republicans want to keep the waiver in some form — either by requesting a new one or reversing the rescission entirely — Democrats have used the opportunity to propel their attempts to expand Medicaid forward. 

Democrat-led solutions, however, are proving unsuccessful. Neither version of this session’s Medicaid expansion bill has received a committee hearing, and attempts by House Democrats to amend the state budget to include an alternative to Medicaid expansion failed last week.