Texas requests waiver to give more flexibility to Medicaid recipients amid coronavirus

Mar. 26--Gov. Greg Abbott announced Thursday that Texas has requested a waiver from the Centers for Medicare and Medicaid Services that would grant greater flexibility to Texans on Medicaid amid the novel coronavirus' spread.

If approved, some of the allowances would include temporarily extending existing prior authorizations for services, allowing services to be performed over telehealth, and streamlining enrollment for out-of-state and new providers.

"The flexibilities we are requesting will help ensure Texans on Medicaid continue to have their routine needs met, even as the state responds to COVID-19," Abbott said in a statement.

Texas Health and Human Services Commission will also request increased flexibility for requirements related to hospitals, long-term care providers, intermediate care facilities, and home and community-based services, according to a news release.

As of Thursday, at least 23 states have been approved waivers for Medicaid provisions. If granted, the provisions would remain in place for as long as necessary during the public health emergency. The Centers for Medicare and Medicaid Services previously issued blanket waivers for some requirements.

Abbott has previously urged health insurance providers operating in Texas to waive costs associated with diagnosing and testing for COVID-19, waived regulations related to hospital capacity and license renewal for nurses, and fast-tracked licensing for out-of-state medical professionals.

Rep. Garnet Coleman, a Democrat from Houston who previously called for Texas to request a 1135 Medicaid waiver, said in a statement Thursday that the provisions in the request will help Texas better respond to the coronavirus' spread, but also urged the state to ask for additional flexibility.

"For example, the state of Washington has requested in their 1135 Waiver to have more liberal eligibility rules, modify eligibility redetermination process to ensure uninterrupted coverage, waive cost-sharing, and provide additional care and services for certain affected populations," Coleman said. "Despite these shortcomings I urge CMS to grant Texas' entire request without delay."

In a letter Thursday, over 50 organizations, including the Texas Hospital Association, Texas Nurses Association, American Heart Association, Texans Care for Children, the Center for Public Policy Priorities and the Children's Defense Fund-Texas sent a letter to Abbott urging the state to ensure access to health care amid the pandemic.

The coalition also urged Abbott to expand Medicaid and call for federal officials to open a special enrollment period for purchasing insurance.

"In the wake of an infectious disease that threatens all Texans, accepting federal funds to offer insurance to low-wage workers is a necessary action to protect the health and safety of Texans," the letter read. "Coverage will encourage timely testing, provide much needed treatment, and provide more financial stability for families struggling with reduced earnings."

Texas leads the country as the state with the highest rate of uninsured residents at 17.7% -- a little over 5 million people -- and nearly double the national average.

Texas is one of 14 states that have yet to expand Medicaid under the Affordable Care Act, and a Census Bureau report found that in states that expanded Medicaid eligibility, the uninsured rate in 2018 was 6.6%, compared with 12.4% in states that did not.

Texas is leading a lawsuit that has the potential to shake up the nation's health care system by striking the ACA in its entirety.

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