Federal Judge Sides With Texas Against Biden Administration in Medicaid Dispute
A judge of the U.S. District Court for the Eastern District of Texas has ordered the Biden Administration to reverse itself after it rescinded a funding agreement, known as a Medicaid 1115 waiver, which had been negotiated under the Trump Administration.
The 1115 waiver reimburses hospitals for the uncompensated care that they provide to patients without health insurance and pays for health care projects that serve low-income Texans. The extension approved under the Trump Administration would have lasted until 2030.
But the Biden Administration determined that rescinding the agreement would push Texas toward expanding Medicaid, according to federal officials cited anonymously by The Washington Post inan April news report.
Texas is one of just 12 holdout states that haven’t expanded eligibility for Medicaid under the Affordable Care Act, also known as Obamacare.
Judge J. Campbell Barker wrote in a 26-page opinion, “In January 2021, a federal agency approved Texas’s request to extend and amend the State’s long-running, managed-care system for the delivery of most Medicaid services. Texas and numerous medical-service providers relied on that approval, investing heavily in and counting on implementation of the extension and amendments.”
“A few months later, in April 2021, the agency announced that it had revisited the matter and had wrongly excused a procedural step allegedly needed to issue the approval, so the agency was rescinding and withdrawing that approval.”
“Turmoil in the State’s Medicaid program resulted, as did this lawsuit… After briefing and oral argument, the court denies the motion to dismiss and grants the motion for a preliminary injunction” wrote Barker, an appointee of Donald Trump in 2018.
The injunction is preliminary, meaning that Barker could later reverse himself and enter a final judgment in favor of the Biden Administration. But he wrote that Texas had a “substantial likelihood of success on the merits” in the case.
Barker’s decision was based on a reading of the Administrative Procedure Act, which, he said, “prohibits agency actions that are arbitrary, capricious, or an abuse of discretion. 5 U.S.C. § 706(2)(A). An agency must examine the relevant circumstances and articulate a satisfactory explanation for its action, including a rational connection with the choice made.”
He added, “Agency action is lawful under arbitrary-and-capricious review only if it rests on a meaningful consideration of the relevant factors.” Barker said the agency had left no meaningful public administrative record of the factors that it weighed in its decision.
Judge Barker formerly served as deputy solicitor general in the Texas Attorney General’s office, which brought the case against the Biden Administration.
Attorney General Ken Paxton released a statement Friday calling celebrating the injunction.
“The Biden Administration continues to believe they can violate federal law again and again. here, their disgusting power grab would have ripped a $30 billion hole in Texas’s budget, as well as sacrificed the well-being of many vulnerable Texans, on top of this move being a flagrant violation of the fundamentals of a constitutional republic.”
The Texas Hospital Association had lamented the end of the federal program. President Ted Shaw said in April that he was “extremely disappointed” with the rescission of the 1115 waiver, adding, “The waiver extension would have helped the state to seamlessly continue support for much-needed health care improvements and would have continued stable funding for hospitals that serve large numbers of uninsured patients.”
During the recently concluded regular legislative session in the spring, Texas Democrats pushed for the legislature to expand Medicaid eligibility in Texas, but most Republicans oppose the idea. Opponents of Medicaid expansion argue that it is a poorly managed and unsustainable program that encourages government dependence. Supporters say that Texas has poorer health outcomes on account of high rates of uninsured and rising medical costs.
Originally published at https://www.honestaustin.com on August 20, 2021.
