Biden Administration cancels Texas’ 1115 Medicaid waiver

May 3, 2021


In a move that will significantly reduce mental health services in Collin County, the Biden Administration has rescinded Texas' 10-year 1115 Medicaid waiver extension that was previously approved by the Trump Administration.

The 1115 waiver reimburses hospitals for the “uncompensated care” they provide to patients without health insurance and pays for innovative health care projects that serve low-income Texans. The extension would have provided hospital reimbursements until September 2030.

The reversal appears to be an intentional effort by the Biden Administration to withhold these essential funds from Texas hospitals and health care providers unless the state agrees to the Affordable Care Act’s Medicaid expansion. The Washington Post, citing "two federal health officials," suggested the recent reversal under the Biden Administration was an effort to force Texas to expand Medicaid services.

"The State of Texas spent months negotiating this agreement with the federal government to ensure vital funds for hospitals, nursing homes, and mental health resources for Texans who are uninsured. With this action, the Biden administration is deliberately betraying Texans who depend on the resources made possible through this waiver,” Gov. Greg Abbott said in a statement.

If the waiver isn’t renewed, LifePath Systems in Collin County stands to lose $6 million per year in federal funding, roughly a quarter of its annual behavioral health budget. The cancellation of the waiver will adversely impact residents of Collin County by reducing the availability of mental health and substance abuse services.

"This reckless and partisan decision by the Biden Administration will take away critical mental health funding in Collin County," said Collin County Judge Chris Hill. "Thousands of Collin County families depend upon the services that have now been canceled by the Biden Administration. The Commissioners Court always strives to improve the quality and the availability of services for our community, but the loss of $6 million will be very difficult to overcome."