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Chris Traylor

Feds grant 15 month Medicaid waiver extension

I sure hope they keep the pressure on to expand Medicaid during this time.

It's constitutional - deal with it

It’s constitutional – deal with it

The Obama administration has agreed to temporarily keep some federal Medicaid money flowing into Texas to help hospitals treat uninsured patients, a relief to health care providers that feared losing the funds over state leaders’ refusal to provide health insurance to low-income adults.

State health officials said Monday they have struck a deal with the federal Centers for Medicare and Medicaid Services to keep the program going for another 15 months, with hospital reimbursements remaining at their current level.

Those were the exact terms the Texas Health and Human Services Commission asked for last month. Agency leaders said the negotiations were a “big win for Texas.”

“We’re pleased these innovative programs will have the opportunity to continue,” Chris Traylor, the agency’s executive commissioner, said in a statement. “These programs are improving health care for Texas’ Medicaid clients and creating cost-savings for taxpayers.”

[…]

The 15-month extension also includes an additional $3.1 billion for DSRIP initiatives.

The Obama administration had previously signaled it was likely to stop footing the bill for at least some of Texas’ uncompensated care costs. Under the Affordable Care Act, the president’s signature health law, Texas was encouraged to expand its Medicaid program to cover nearly 1 million additional adults living in poverty — a move that would have given more poor patients a means to pay for care. The state’s Republican leadership hasvehemently opposed that option, criticizing Medicaid as an inefficient government program.

Federal health officials were unswayed by that argument, repeatedly telling state leaders they had no desire to use waiver funds to pay for costs that would otherwise be covered by a Medicaid expansion.

[…]

Texas health officials say they will continue negotiating a longer term extension of the funding over the next 15 months.

Those negotiations will likely be influenced by a study of the effectiveness of the uncompensated care pool, which the federal government asked Texas to commission. The Texas Health and Human Services Commission contracted with outside firms Health Management Associates and Deloitte to submit the study by the end of August. It will address questions such as how hospitals’ uncompensated care costs would be reduced under a Medicaid expansion.

If Texas and the federal Centers for Medicare and Medicaid Services do not reach an agreement at the end of the 15-month extension, in December 2017, the Obama administration said it “expects” that uncompensated care funding would be reduced after that.

“Specifically, the reduction will limit the size of the Uncompensated Care pool to the costs of uncompensated and charity care for low-income individuals who are uninsured and cannot be covered” under a Medicaid expansion, wrote Vikki Wachino, a senior federal health official, in a letter to the Texas Health and Human Services Commission.

Additionally, the DSRIP pool would be reduced by 25 percent in 2018 and by an additional 25 percentage points each year after that, according to federal officials.

See here, here, and here for some background, and here for a copy of the letter CMS sent to Texas. I don’t really have anything to say that I haven’t said before. Texas needs to expand Medicaid, and if the state continues to refuse to do so, the federal government should not take any steps to mitigate the consequences of that decision. It’s up to the next Legislature now. State Rep. Garnet Coleman, Trail Blazers, and the Austin Chronicle have more.

Refugee group defies Abbott

It’s on.

A nonprofit organization that resettles refugees in the United States says it will move forward with the placement of Syrian refugees in Texas, despite warnings from officials in the Lone Star State not to do so.

The New York-based International Rescue Committee said in a Monday letter to Texas health and human services chief Chris Traylor that its Dallas affiliate would continue to provide resettlement assistance to all refugees “who have been admitted lawfully to the United States.”

The nonprofit had received a letter earlier on Monday from Traylor urging the International Rescue Committee’s Dallas branch to discontinue resettling Syrian refugees or risk losing its state contract “and other legal action.” The International Rescue Committee – one of about 20 nonprofits that have a state contract to resettle refugees in Texas — had previously informed the state that it would resettle two families in the Dallas area in early December. Both families have relatives in North Texas, the nonprofit said.

See here for the background, here for the letter from HHSC to refugee groups, here for the IRC’s response letter to the HHSC, and here for their public statement. I’ve said before that I have a hard time believing that Greg Abbott would go to the mat against faith-based organizations like the IRC, but these are the time we live in. The next question is how much company the IRC will have in litigation against the state of Texas, if indeed it does come to that.

At least 242 Syrian refugees have been resettled in Texas since 2012. That number is relatively small for Texas — a hotbed for refugee resettlement — but the count of Syrian refugees was expected to increase significantly in the next year as the United States prepares to take in 10,000 Syrian refugees.

At least one other resettlement nonprofit, Catholic Charities of Dallas, had said it would continue to provide resettlement assistance to Syrian refugees. But as of Monday afternoon, that organization had not received a letter from the state similar to the one received by the International Rescue Committee, a Catholic Charities spokeswoman said.

[…]

The Texas Health and Human Services Commission was unable to provide a list of resettlement nonprofits that have agreed not to assist Syrian refugees.

At least two such nonprofits in Texas say they haven’t made a decision about whether to continue settling Syrian refugees.

A spokeswoman for Interfaith Ministries for Greater Houston said in a statement that it had not received a letter from the Texas Health and Human Services Commission, “so no final determination has been made regarding our next steps for resettling Syrian refugees.”

Likewise, Refugee Services of Texas had not received a letter from the state about Syrian refugees, said Aaron Rippenkroeger, the president and CEO. The organization plans to “seek guidance on the ramifications” of federal and state requirements,” he said in a statement.

The more organizations that stand with the IRC, the harder I think it will be for Abbott to follow through. There’s got to be a way to ease up and find a compromise, but I have no faith that Abbott wants to do that. TFN Insider has more.

Texas threatens to sue religious groups over refugees

Amazing.

Texas officials are escalating their opposition to Syrian refugees with a new order aimed specifically at resettlement groups that have indicated they will accept people fleeing the war-torn country: change your mind or risk getting sued by the state.

Texas health commissioner Chris Traylor issued the first lawsuit threat over the Thanksgiving holiday weekend in a letter to the Dallas branch of the International Rescue Committee, which said earlier this month that it supports accepting Syrian refugees.

“We have been unable to achieve cooperation with your agency,” Traylor wrote in the letter, which was released to the Houston Chronicle, adding that, “Failure by your organization to cooperate with the State of Texas as required by federal law may result in the termination of your contract with the state and other legal action.”

Similar letters are expected to be sent to any refugee resettlement group that takes a similar position against Gov. Greg Abbott.

[…]

Bee Moorhead, executive director of Texas Impact, a faith-based organization that has ties to refugee groups and has expressed concern about Abbott’s position, decried the letter in an interview with the Chronicle.

“This letter should raise serious concerns for refugees currently receiving assistance in Texas, and also for legislators – who should be asking what fiscal impact the Texas Health and Human Services Commission could be bringing down on the state through its increasingly contentious communications,” Moorhead said. “The health commission interacts collegially and effectively every day with multiple federal agencies, so it’s astonishing to see these kinds of communications coming from the agency.”

See here, here, and here for the background, and see the Chron story for a copy of the letter. I continue to be utterly gobsmacked by this. Again, these are faith-based organizations that Abbott is blithely threatening to sue. We all know how this would play out if the federal government were doing something like this, right? I mean, we’re all familiar with the apocalyptic rhetoric surrounding the contraception mandate. At what point does the Catholic Church in Texas quit pussyfooting around and condemn Abbott for this in no uncertain terms? That might loosen things up a bit. Beyond that, I still have no idea how this ends. Trail Blazers, the Press, and the Current have more.