Dallas Healthcare Daily

By Matt Goodman

Although an extension for its expiring Medicaid waiver will keep billions flowing into Texas safety net hospitals through December 2017, healthcare advocates are beginning to reiterate that the legislative refusal to expand Medicaid (or find an alternative) is costing the state more than three times as much in federal funds as it is bringing in. And, judging by how the feds have renegotiated with states like Florida, experts warn that the chasm between the waiver funding and full expansion will almost certainly grow wider once the extension runs out.

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Florida, another non-expansion state, saw its uncompensated care funds drop by more than 40 percent in its renegotiated waiver. The feds’ goal, says Georgetown University’s Joan Alker, is to provide access to care “up front, rather than give hospitals money on the backend.” She adds, “We would expect to see cuts of this magnitude for Texas as well.”

“It’s a very fiscally foolish decision,” Alker said. “Texas should expect considerable cuts in federal funds. I think the CMS letter was very clear on that.”

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